Belladonna

Authorities. (242 to 254, from Dr. Dufresne’s collection. Bib. Horn., vol. i, 1833, p. 319.) 242, Wade, Lond. Med. Journ., 1827 ; 243, Rave, Act. Reg. Sac. Med. Havn., vol. ii, p. 346; 244, Jolly, Nouv. Bib. Med., 1828, e&cts of 44 grains of the extract; 245, Dufresne’s observations; 246, Darlac, Journ. de Med. de Vandermond, 1759; 247, Smith, Journ. de (him. Med., 1827, poisoning by the berries; 248, Munnicks, Bib. Ther., 1823, poisoning of seven children ; 249, Streeker, Rust’s Mag., vol. xxv, 1828, effects of a solution of the extract rub)ed into the skin with oil, in a woman in labor; 250, Brandies, Archiv, vol. xxviii, p. 52 ; 251, Lemercier ; 252, Hecker’s Annals ; 253, Kennel, Hufeland’s Journ.; 254, Reiner, ibid., vol. X ; 255 (Nouv. Biblioth. Med.), Lancet, 1828-9 (1), p. 45, a man, aged forty-six, swallowed 44 grains of the powder; 256, Lancet, 1846 (2), p. 251, a man ate a tart made of the berries; 257, ibid., effect on a child ; 258, Pharm. Journ., vol. vi, 1847, p. 174, a man, a^ed thirtyfourth years, and a child, aged three years, ate a pie made of the berries ; 259, Dr. Layman, Bost. Med. and Sur. Journ., vol. Iv, 1856, p. 451, a woman, aged twenty-nine, wore a Bell, plaster for several days; 260, Wm. Jenner, M.D., Med. Times and Gaz., 1856 (2), p. 513, a man applied a Bell, plaster to his back, which was covered with pustules; 261, James Seaton, Med. Times and Gaz., 1859 (2), p. 551, poisoning of ten persons by the berries; 262, Dr. Golding, Lancet, 1859 (2), p. 560, a boy, aged ten years, swallowed a mixture of extract with water; 263, ibid., a boy, aged ten years, took a teaspoonful of the undiluted tincture; 264, Dr. H. Thompson, Lancet, 1859 (2), p. 561, poisoning of a child, aged seven years, by the extract; 265, Geo. W. Quimby, Bost. Med. and Surg. Journ., vol. Ivii, 1857, p. 389, took nearly a teaspoonful of the pure extract in its pasty state, in two-thirds of a tumbler of water; 266, G. T. Evans, M.D., Brit. Med. Journ., 1861, p. 305, a girl, aged nine years, ate four berries; 267, Dr. Frazer, Lancet, 1865 (2), p. 536, a girl, aged eighteen years, applied the extract to her breasts; 268, H. Taylor, M.D., Brit. Med. Journ., 1869 (2), p. 555, a young man swallowed about a drachm of the extract dissolved in half a teacupful of warm water; 269, Dr. Beddoe, Lancet, 1870 (2), p. 83, a woman, aged sixty-six, swallowed about a teaspoonful of Bell, liniment; 270, Chas. W. Parsons, M.D., Bost. Med. and Surg. Journ., vol. Ixxxvi, 1872, p. 384, a boy, aged four years, took within one hour and three-quarters, 6 grains of extract; 271, Sharps’s Essays, 1874, p. 770 ; 272, Dr. S. Ringer, Lancet, 1876 (1), p. 347, a man, aged sixty-four years, drank about 2 drachms of liniment; 273, ibid., a girl, aged four years, drank over ^ an ounce ; 274, Dr. A. Colon, U. S. Med. Invest., New Series, vol. iv, 1876, p. 314, poisoning of six children by the berries; 275, ibid., p. 315, a girl, aged two years, drank about one-fourth of a glass of water containing 4 drops of tincture ; 276, John Herewith, M.D., Brit. Med. Journ., 1876 (2), p. 678, a woman, aged fifty years, swallowed some liniment; 277, H. L. Morton, M.D., Phila. Med. and Surg. Rep., vol. xxxiv, 1876, p. 464, an infant swallowed 45 grains of extract; 278, H. F. Smith, M.D., Brit. Med. Journ., 1877 (1), p. 259, a man, aged seventy, with commencing orchitis, applied a liniment on lint to the scrotum ; 279, Dr. Thomas, Am. Journ. of Obs., 1877, p. 298, poisoning of a woman from the application of the extract to a rigid os; 280, Alfred Cooper, Brit. Med. Journ., 1877 (1), p. 164, poisoning of a man from the application of the extract to the scrotum ; 281, J. D. Whitley, M.D., Chicago Med. Journ. and Exam., vol. XXXV, 1877, p. 271, a child, aged three years and a half, swallowed a teaspoonful of extract; 282, J. N. Smith, M.D., Med. Rec., vol. xii, 1877, p. 397, for an attack of trifacial neuralgia, took 5 grain of alcoholic extract, thrice daily; 283, F. A. Burrall, M.D., Med. Rec., vol. xii, 1877, p. 431, Mrs. W., applied a Bell, plaster upon her right side; 284, John Dewar, Lancet, 1878 (1), p. 18, a woman inserted a pessary containing 2 grains of Bell, into her vagina ; 285, E. L. Parks, Bost. Med. and Surg. Journ., vol. xcviii, 1878, p. 551, a man, aged twenty-eight years, took 1 drachm of extract at 2 P.M., and li drachms at 4 p.m.

Mind p. 374

Delirium

Great delirium, with lucid intervals

Wildly delirious, but quite fantastic, almost hysterical, laughing wildly and crying, and not at all conscious; pupils widely dilated; he evidently saw visions, as in delirium tremens, for he was constantly grasping and picking at imaginary objects; the odor of Belladonna was strong from his hands and feet; quite blind, and stared vacantly

Violently agitated. tliroAving his limbs about, groaning and moaning. Apparently unconscious, and did not speak, nor attempt to do so. These symptoms continued for an hour and a half without intermission. He then became comatose, and so continued till his death

After three hours she was very delirious, talking fast, and throwing about her arms in an excited but feeble way; her pupils were widely dilated and insensible to light; her pulse was 126. Three-q quarters of an hour later she was very restless, tossing about the bed, picking at the bedclothes, and throwing about her arms in a meaningless way, but partially conscious of what was said to her. A calabarized disc was placed in one eye (the left); in about twenty minutes the left pupil had contracted to a pin’s point, the right pupil remaining widely dilated and insensible to light; the eyes continued thus till death, which occurred sixteen hours alter taking the poison

He was quite delirious, the delirium being of a mild vagarious or fantastic character. He could neither hear nor speak plainly, and labored under hallucinations, but was otherwise unconscious. The pupils were widely dilated, and the eyes had a staring look. At first he complained of pain in his throat and of imperfect sight, objects appearing white to him. His pulse was feeble, and almost countless. Urine small in quantity for the first twenty-four hours

The symptoms were similar to those in case one, with the addition of a flushed face, more active delirium, the grasping at imaginary objects and picking of the clothes being also much more marked

Immediately after the second draught he walked out, and noticed at once dimness of vision, dryness of mouth and throat, constriction of fauces, a feeling as if the tongue was enormously swollen, dulness of intellect, and weakness of knees, with want of muscular co-ordination. Having reached his room at 6 p.m., two hours after second dose, he became alarmed at his symptoms, called his landlord to his assistance. The patient was running up and down the room, drinking large draughts of water, upsetting pitchers, and in danger of falling. Medical aid was summoned at once. It was noticed at this time that the tongue was very red, and the secretion of urine increased. There were hallucinations like those of delirium tremens, disagreeable, vanishing instantly, and immediately after their departure the patient was aware of their unreality. The yellow corpse of a tall man, shrouded in white, tried to share the patient’s bed with him, and the unwelcome visitor was promptly ejected. A crimson serpent came from the foot of the bed, with the design of fastening upon the patient’s neck. Rising to his knees, he with his fist drove the serpent’s head deep into the bed, and instantly the apparition vanished. He asked his attendant (for he was practically blind) if the blanket had a red border to account for the hallucination. There were large sea-turtles about the room, such as he had seen in the Pacific. After an hour or two of sleep in the early morning the delusions became agreeable, and continued all day. While riding out in the afternoon with a medical friend, trees became personified to him as people in fantastic costume. In the morning there was severe pain in both renal regions, which he partially relieved by pressure with his fists, the elbows planted in the bed, and the body raised in that way quite off the mattress. Further details are given derived from medical attendants. The delirium was “most busy Picking things from the bedclothes, rising in bed to gather things from the pictures and walls, muttering to himself, he had little time to notice those about him. Great mental and physical prostration, sleeplessness, and pain in the left kidney followed the accident

He was very restless and noisy. He was continually getting in and out of bed, and talking loudly and incoherently to imaginary persons, who, as he said, were trying to take away his bedclothes. He complained of faintness, and of soreness and dryness of the throat, and pain across the forehead. He had vomited once and had been several times to the water-closet. He said his sight was all right, but evidently did not know what he was saying. Temperature 98.5° ; pulse 140, very weak. The skin was moist; the face flushed. The pupils were widely dilated and quite insensible to light

All but two had delirium of a busy, restless, vivid character, but generally rather pleasing than otherwise. The patients appeared to think that they were pursuing their ordinary occupations; one boy appeared eager in flying a kite; another pulled tables and chairs about, thinking he was working in a coal pit; while the woman appeared remarkably busy with her ordinary household duties. All their movements were of a quick excited character, strikingly resembling delirium tremens. In none of the cases in which delirium was present were the symptoms alleviated until sleep was obtained ;' and after sleep, the patients felt comparatively well,^®h

General excitement. This was followed by giddiness, a feeling of intoxication, and a disposition to quarrel, laugh, and talk. The pulse became accelerated, and the mind filled with hallucinations, which increased to a state of absolute madness. This state lasted from one to twelve hours, and was then succeeded by one of insensibility, somewhat similar to that of a person in the last state of intoxication. In the fatal cases, this state lasted to the end

She began to snatch at objects on the floor and elsewhere, which objects only existed in her own fancy. These visionary phenomena were, by her talk, found to be chiefly articles of work and various insects, beetles, flies, etc. (after five hours). As evening came on, she became nearly blind, restless to an inordinate degree, excessively and loudly talkative, incoherent and unmeaning in her words, which almost wholly, along with the movements of lier hands, betokened a concern in her employment, or some immediate interest in her brothers and sisters who were not present. The tongue became somewhat dry, thick frothy mucus adhering to its sides. The skin was still more hot, and the pulse as high as 120. The delirium from this time rapidly increased; at one time expressive of great joy, at another great terror

What was particularly observable in this case was a great deal of exhilaration or flow of spirits; a marked stimulation of the brain. The child did everything in a hurry, and saw the bright side, rather than the dark one, of what was observed. The Belladonna was taken about 4 p.m. The greatest amount of excitement or stimulation showed itself between 7 and 8 p.m., and it was fully 11 p.m. before she could be quieted so as to fall into a disturbed sleep

Appeared dazed, and was ignorant of what had occurred, like one who had had an epileptic attack (.second dav)

Seems to see birds flying past and wishes to follow them

She moved her hands as though she wished to seize something,'^‘h

His speech is disconnected

Rage and convulsions, with grinding of the teeth

Laughs in the most extraordinary manner

Laughing and talking alternately,'

Constant loquacious delirium, he talks without cessation of the pains at the neck of the bladder

Taciturnity

Remarkable loquacity

Extreme anguish and agitation

A few minutes after eating the tart he became drowsy, his lethargy soon increased, his countenance changed color, and the pupils of his eyes became dilated; had a strange coppery taste in mouth ; staggered on going upstairs, and fell down insensible. He subsequently became delirious, and was very rough. His contortions were dreadful. He attempted to strike his wife in his delirium, and when he recovered a little, said he was sorry, and asked her to kiss him

f2570.] Comatose condition, in which she died (one case)

Head p. 377

Contusion of head

Vertigo

Vertigo, with malaise

On getting off the couch she was noticed to be giddy and confused (after five hours)

Instability of the body, without vertigo

Heaviness of the head

Pain in head

Violent headache, particularly in the orbital region, accompanied by extreme redness of the eyes and face; the redness gradually extended over the whole b()dy, and after a few minutes the whole skin was as red as in scarlet fever

Eyes p. 377

Eyes sunken 242_

Eyes haggard and brilliant

Lids widely separated

Pain in eyeballs, which felt as if starting from their sockets

Papil. Pupil dilated

Extreme dilatation of the pupils, with sensitiveness

Pupils widely dilated while the delirium continued

Pupils greatly dilated, not contracting in ordinary light, and very moderately contracting in full sunlight (after two hours and a quarter)

Pupils insensible

One drop of the tincture was added to ninety-nine drops of water, and the right eye was rubbed in the usual way, but no effect was perceived. Afterwards one drop of tincture was added to nine drops of water, and this was applied in the same manner’, again no effect was noticed ; then a drop was added to four drops of water, and applied ; this experiment succeeded, a perceptible contraction of the pupil was noticed. Some months later the last-mentioned experiment was repeated at noon. Two drops of tincture were added to eight of water. Small portions of this dilution were rubbed over the eye at intervals during half an hour. At the end of this time the pupil was slightly contracted, it was less than that of the other eye. Afterwards the remainder was rubbed over the same eye, at intervals during another half hour; a slight dilatation of this pupil was noticed, it was larger than the other. This dilatation afterwards increased considerably, and had not disappeared on the following morning

Vision. Weakness of vision; it is difficult to distinguish letters, and he is obliged to hold the paper at a greater distance than ordinarily

Indistinctness of vision

Disturbance of vision; all objects seemed bordered with yellow

Disturbance of vision wholly confined to the right pupil, which was widely dilated, not responding in the least to alternate light and shade, while the left was in a perfectly normal condition, and responded readily to light and shade. I continued the remedy for about one week, the right pupil remaining fully dilated during the whole of this time, and for two or three days subsequent to its discontinuance, while the left pupil failed to, at any period of the time, show the characteristic effect of the drug

He had no power to distinguish objects for more than three days

Amaurosis

Double vision and dilated pupil of the same side as that on which the plaster was. The next day the right pupil was still one-third larger than the left

Nose p. 377

Several prolonged its of sneezing

Face p. 377

Flushing of the co?mtenonce

Redness and swelling of the face and lids

Face deep red

Risus sardonicus

Convulsions of the jaws and of the miracles of the face and extremities

Spasms of the jaws

Spasmodic constriction of the muscles of the jaws

Mouth p. 377

Tongue covered with a white clammy fur, which he could pull off in strings

Tongue dry and retracted (after nine hours and a half)

Tongue and throat extremely dry

Tongue pale, dry

The tongue sticks to the throat on attempting to spit/^®.

Unpleasant metallic taste in the mouth (after ten or fifteen minutes)

No taste to food

Moved mouth incessantly, evidently with the idea that he was talking, but the sounds he uttered were inarticulate and altogether unintelligible

Difficulty in speaking, articulation indistinct

Loss of speech *®®.

Throat p. 378

Intense redness and heat in the throat and alimentary canal

Dryness of the throat and great difficulty in swallowing

Dryness and heat in the throat

Very great dryness of the throat and oesophagus

Sensation of burning heat in the throat

Dryness and heat in the throat and pain

Heat of the throat and lips

Very deep-red color of the mucous membrane of the fauces and palate

Tonsils swollen,'

Deglutition difficult, with heat in the throat

Swallowing difficult

Paralysis of the throat, which impedes deglutition

Unable to swallow (after one hour and a quarter)

Stomach p. 378

Loss of appetite

Loss of appetite, with loss of taste

Loss of appetite, with a sensation of feebleness

Thirsty (after one hour and a quarter)

Unquenchable thirst

Nausea, with efforts to vomit

Vomiting

Extreme distension of the stomach and bowels

Urinary Organs p. 378

Extremely painful irritation of the urinary organs, and especially of the neck of the bladder; the patient constantly desired to urinate ; though making every effort the urine passes only guttciUm; urine very red and bloody

She complained of pain in the region of the bladder, placing her hands on the pubes, and uttering words expressive of desire to pass urine. A catheter was passed amid violent physical opposition and a tremendous torrent of abuse; but only a few drops of urine flowed (after thirteen hours)

Excessive desire to urinate, but the urine is bloody and the emission pale

Excessive desire to micturate, though he could pass only a few drops of perfectly colorless urine

Urine passed ^wftofm

Respiratory Organs p. 378

Hoarseness (after ten or fifteen minutes)

The voice naturally hesitating and thick, became during the delirium so sharp and clear that the father would not have recognized it as his child’s

Cough resembling croup

Deep respiration, as in croup

Respiration irregular

Nose p. 378

Pulse 110 (after two hours and a quarter) ; afterwards 120,*®®.

Pulse small, rapid

Pulse very feeble

Pulse imperceptible (after four hours)

Upper Extremities p. 378

Limbs are violently agitated

Weakness of the limbs,'

He could not stand till afternoon, and then could only walk with assistance (second day)

Generalities p. 378

The whole body is in perpetual movement

Convulsive catching of the extremities, face, and trunk, such as animals have when bitten by venomous serpents

In a few minutesshe vomited slightly, and in less than an hour after she commenced having spasms, which continued, alternated with periods of repose, until two hours and a half later, when she appeared to be sleeping soundly. Pulse 130; repirations 20 per minute; the entire surface of the body was covered with a very bright scarlatinal eruption, with occasional livid spots of variable size. Upon lifting the eyelids found the pupils dilated to such an extent that only a very small circle of the irides remained visible

The child was in his mother’s arms, or partially so, as there did not appear to be a muscle in his body but what was in spasmodic action, especially those of the extremities. The skin, in color and to a certain extent in thickness, had the appearance of scarlet flannel; the teeth were tightly clenched, with a little froth flying out between them at each irregular spasm of the muscles of expiration; eyelids widely separated and fixed; pupils dilated to their utmost extent, and immovable; totally insensible; pulse could not be counted on account of the incessant muscular twitching,’’k

Immediately after last dose stupor, swelling around the throat and jaws, great flushing of the face, and dilated pupil. The flushing extended to and even above the roots of the hair on the frontal region. It was difficult to rouse the child ; he stared when awakened, and was hard to control. He made wild resistance to anything done for him ; if left quiet went off soon into a stupor. The heart was acting violently, beating hard, and more than 144 in the minute. Had illusions; saw visions on the floor; talked nonsense. Passage of an ounce of dark-colored urine

In five minutes she was drowsy but conscious. The skin vas very dry; the pupils widely dilated; face flushed. The skin flushed more readily than natural on irritation. She soon fell asleep, and woke three hours and a half after the poisoning, when she yawned and sneezed frequently. After this she fell into a doze, and woke in a second or two with a cry, and with slight convulsive movements. She tossed about a good deal. In four hours and a half she was very delirious, had unpleasant illusions, and screamed from fright. She followed with her eyes, in a rapid manner, imaginary objects. She tried to talk, but her words were inarticulate. There were slight convulsive twitchings. She did not know her mother, nor could her attention be attracted by objects held before her eyes. The skin was very dry. At about this time a deep, sharply-defined, uniform blush appeared on her face, neck, arms, trunk, and thighs. The delirium continued, but in about eleven hours the delusions appeared to be of a more pleasant character, and she occasionally laughed, and from this time on she continued to improve

Three presented marked symptoms of poisoning. One showed the following effects: He was a boy four years of age, and he ate the berries about twenty minutes before 3 p.m. At 3 oclock he was sleepy, and lay down. About ten minutes later he had marked twitching and jerking of the hands arid, slightly, of the lower limbs. He would partially awaken, and then instantly fall asleep again. The nervous tr-errors continued all the time, and rather increased. The above symptoms continued for about an hour and twenty minutes from the time of the poisoning, when an emetic of Sulphate of zinc was administered. This produced a rather copious watery discharge from the stomach, with a few- fragments of the Atropa berries. Then an entirely new set of symptoms supervened. The child was wakeful, and made passes as if picking u{) things, and would appear to pour them from hand to hand. He would run against things backward, sideways, and forward ; then he would whirl on one foot, and run against things as befoi-e. In the midst of these movements he presented an episode, by throwing up his hands and asking a blessing, by then calling for bread, and appearing to think he had it, by taking up his apron and biting a piece off and chewing it. He immediately followed this by talking of his father and mother-, who were at a distance. Again, he would throw things at persons around him, catching at anything that was within his reach. The above was the most marked case of poisoning among these children. The others pr-resented far less demonstrations, their delirium being of a much more painful order. The effects had sensibly diminished by the next morning, and had entirely disappeared on the second day

Shortly afterward became insensible, with rigidity of the body and clenched teeth. Breathing with a loud snoring noise, but without puffing out the cheeks; the skin, lips, and mouth dry; pulse 104; respiration 22 (after two hours aud twenty minutes). Contractions and twitchings of both arms, the fingers being clenched by tonic contraction of the muscles, and the elbows rigid (after three hours and twenty minutes). Half unconsciousness began to give way to fussy busy delirium. He constantly muttered, kept picking the bedclothes, and tried to get out of bed. He stared wildly about him, and was very suspicious. He continued delirious, but not violently, all that night and the next day (after ten hours and a half). Became so violent that it was necessary to lay him down in bed. He stared wildly about him, struggled to get out of bed, shouted at the top of his voice, “Police!” “IMurderl and suffered from various hallucinations, thinking he was in prison, or was about to be murdered. He was very suspicious, refusing to take food, thinking it was poison (after thirty-six hours)

“ In about five minutes to use her own words, she “felt queer about the eyes, then stupid like in her head; felt she was losing the power of standing on her legs. She became helpless and quite unconscious. In less than an hour, when I saw her, she could swallow only a few drops of water, and very soon she became unable to do this. She could not speak, only mumbled incessantly some inarticulate words, which were only audible at times. She was put into bed, and there she sat propped up by pillow's, and had a vacant, drunken look ; moved her hands about, sorting and catching at imaginary things. Widely-dilated pupils, and a diffused scarlet rash, which was out on the neck and upper part of the chest, and also on the hand and forearm. The rash was not of a long duration ; it soon began to fade, and in four hours was hardly perceptible anywhere. For about twenty-two hours her life was a blank to her. On the morning of the second day, her pupils were widely dilated, and she saw persons and things double, and at times saw imaginary persons and objects about her; her hands felt moist, as did also her feet, and she could not stand. All through there was a good deal of distress about the throat; it was one of the first things experienced, and the discomfort lasted to a certain extent for many days. The patient eventually recovered ; but for several days she felt she was not her ordinary self; could not remember how to do the simplest thing, had forgotten the way ; had to ponder over the way an article of clothing should be fastened on, etc.,^’®.

In fifteen or twenty minutes after I had taken it, I felt a very disagreeable sensation in my chest and head, and slightly in my stomach. It seemed to me as if there were an accumulation of wind at the pit of the stomach, which should come up. The vital organs were weary, I wished to draw a long breath every moment, and soon grew worse. My face became flushed. The pupil of my eye was much dilated, covering nearly the entire iris. My head felt full and heavy. Giddiness followed, the room appeared to whirl and the floor to move. There was a sort of constriction in the chest and throat, slightly spasmodic, and a sense of suffocation. This condition rapidly increased in intensity till I felt I was assuredly dying. I could think of no other result. It appeared as if every breath I drew would be the last. I took leave of my family, as I found my voice failing and the sense of vision losing itself in darkness, when I became unconscious. I remained in this position from about 8 oclock in the morning till after dark in the evening. When I came to myself, so as to know those around, the faces of persons look exceedingly large, broad. and out of proportion. Any little speck or spot on the ceiling over head, or on the wall of the room, as large as a fly, for instance, the head of a nail appeared to my vision precisely like a spider with legs, and the legs constantly in motion.f This ap|)earance continued for three or four days, but gradually corrected itself so far as addition to the real object seen went. Still for weeks and months, everything I looked upon, the ground, houses, trees, etc., appeared as if there were a sort of gliturner upon their surface, resembling the wavy motion of heated air arising from the roof or sides of a building. The figures of a carpet seemed to blend as I looked down upon them ; indeed, nothing appeared natural to the vision. My stomach and bowels were torpid and inactive. For weeks and months I had no appetite, much of the time actually loathing the sight and smell of food. One singular sensation I experienced when consciousness was leaving me and immediately on its Return, was this: whatever I touched with my hands felt exceedingly cold. The hands and fingers of my wife were as cold to ray touch as icicles, and the longer I retained them in my hand, with the thought that they might soon become warm, the more intense/y cold did they seem. This feeling was not imaginary, because about the first thing I remembered on coming to myself, when my wife spoke to me and took hold of my hand, was the sensation I have described; but it did not then feel as cold as when I was going into the state of unconsciousness. In four or five days I was able to sit up, and in ten or twehm to go out. But I was weak and trembling, easily excited, quick and hasty in my motions, with a sort of wild and glassy expression about the eye. I felt as if my nervous system was completely shattered. The feelings I have experienced in my brain, at the pit of the stomach, and through my limbs, to which I allude, are difficult to describe. At times when excited or a little weary, and sometimes when there is no apparent cause, even when I feel uncommonly well and bright, I experienced what I call a sort of spasm in the brain. The sensation comes quite suddenly. There is a sort of drawing and giving way, again, as if the nerves of the brain were in motion, when all upon which I look appears to move slightly in one direction, and then back to their former position. If the objects are at a distance, either forests, houses, or mountains, upon which I chance to look at the time, they seem to swing. At these moments I feel as if I should fall to the earth, though I experience no giddiness, but only a strange and alarming sensation at the pit of the stomach, corresponding to the feeling in the brain, and coming at the same moment, as if the two were connected, and the whole on the sympathetic nerves. This sensation was first experienced about two weeks after my prostration. I have since felt it many times, and generally when standing or walking, hat seldom when I either stand or sit xvith my back against something to sustain me. In two months after I was prostrated, I felt those spasms at times so powerfully that it would seem I could not live if they should continue for the space of a minute. They generally pass off in the space of a few seconds, and do not return for some hours, perhaps not fora day or two,■■'®

Expression vacant, laughing on the slightest provocation. Strong light produced no contraction of the pupils, which were widely dilated. Answered questions when aroused, but soon became incoherent; vessels of retina rather enlarged : pulse 114

I All the symptoms which 1 have described above, followed in the case of my sister, who took but half the amount 1 did. She, however, did not become unconscious. quick; extremities cold; mouth and tongue remarkably dry (first day). Delirious and very troublesome throughout the night; limbs feel numbed; objects appear a long way off, and as if double; sees letters dimly, but cannot read (second day)

The skin was of the color of a lobster ; pulse 130; respirations rapid, sighing, and shallow; the pupils widely dilated, and the patient much alarmed. She looked as if in the eruptive stage of scarlet fever

Dryness of throat, dilated pupils, and great pain in the passage. Vagina very dry, in great pain of a burning-stinging character. Her pulse was quick, the countenance was flushed, tongue dry and parched

Severe pain in the top of the head, vomiting, dryness of the fauces, spasmodic action of the muscles of the throat and chest, and an indescribable sensation of sinking. Pulse quick and thready; irides very much dilated, though contractile; face and eyes suffused, extremities cold, tongue moist, skin dry. Urinated several times with severe scalding and irritation of the bladder^®.

Nauseous taste, like copperas, in her mouth, a tingling in the fingers, and stupor

One hour after swallowing powder, he was attacked with violent headache, especially above the orbits ; the eyes became of a red color, which quickly extended over the face, and at last over the body, so that within a few minutes the whole skin exhibited an intense uniform redness, such as is observed in scarlet fever; at the same time the patient felt violent pain and heat in the throat, and along the oesophagus, and, on examination, the fauces were found strongly inflamed. These symptoms were accompanied by a very painful irritation of the urinary passages, especially of the neck of the blad<ler, with constant but fruitless desire of making water

Restless

Desire to lie down

Skill p. 382

Scarlet redness over the whole body

Scarlet redness over the whole body, with pain and heat in the throat, desire to urinate, and painful discharge of bloody urine

Her body and limbs were covered all over with a beautiful scarlet rash, resembling the rash of scarlatina, but this disappeared in a few hours (after sixteen hours)

Transient redness over the whole body, especially on the chest and neck

Face, neck, and upper part of the chest reddened and congested (after nine hours and half)

In about one and a half hours the face of the child was covered with spots the size of a silver quarter, and larger. These spots were of a bright red color, and a little elevated and pufl'y, similar to nettlerash. These gradually coalesced, and in about two hours covered the face and front of the neck. Around the spots was a white border; also around the mouth

Scrotum blistered

Sleep p. 382

Fast asleep (after three hours) ; sleeping quietly without stertor (after six hours and a half); after the application of cold to the scrotum and spine, tickling and pinching the feet and legs, the patient became partially aroused at 3.30 a.m. (after sleeping nine hours and a half) ; he then slept quietly till morning, when he woke of his own accord

Wakeful

Fever p. 382

Skin cold (after four hours)

The lower limbs were inclined to be very cold, and it was with considerable difficulty that they were kept partially warm

Skin hot (after two hours and a quarter)

Profuse perspiration

Additions: Introduction p. 645

Authority. 286, Drs. Flecker, Fraukel, and Schneider, Zeit. der k. k. Gesel. der A^rate zu Avhen, 1847, p. 97, a proving beginning with 2 drops of the tincture, and increasing irregularly to 130 drops.

A dose of 2 to 30 dro})s, es})cially the latter, caused slight dryness of the mouth and nose, insipid taste, yellowish fur on the tongue, diminished appetite, dulness in the frontal region, roaring in the ears, weakness of vision, with normal, rather contracted pupils; in one person, in addition, pain in the small of the back ; in another person stitches in the region of the shoulder, and in the left side in the region of the false ribs. From 35 to 60 drops the above-mentioned symptoms in the mouth and fauces increased to a distressing degree. There was burning in the hard palate and throat, with great redness of these parts, the voice became hoarse, the intestines distended by gas and painful. The head became dull, there were vertigo, sleepiness, and frequent yawning, restless sleep. In two provers there were also transient stitches in the region of the heart, tearing pain in the head, in the region of the shoulders, and in the feet. These symptoms continued in a less degree, even on the following day when nothing was taken. After doses of 65 to 130 drops, the above-mentioned symptoms increased, with the exception of transient pains; the eyes became especially affected, there was foggy vision with vertigo, the eyes seemed covered with a veil, reading was very difficult, the conjunctiva was injected, the pupils in one case, from 110 drops, dilated. Lastly it was noticed that the urinary organs became affected, so that micturition was accomplished with great straining and difficulty. On the same day in which one prover took 110 drops, an experiment was made with an external application to the conjunctiva ; a few drops were rubbed into the upper lid, and some trickled into the inner canthus. About a quarter of an hour afterwards there was some dilatation of the pupil, which increased so that after two hours there was scarcely a line of iris to he seen. The margins of the lids became red, the conjunctiva slightly injected ; even the puj)il of the therese was somewhat dilated. The iris of the right eye was sluggish in action, vision was very weak, air the eyes seemed veiled. On the next day, the rio-ht pupil was still considerably dilated and vision very much restricted, especially in the open air. At theme time the eye was drawn somewhat upward and outward. On the third day vision was only somewhat weak, the pupil remained dilated for several days. The following were the chief observations from twenty-one provings with three different preparations: the mucous mend'>rane of the mouth and fauces was first affected ; thence the affection extended upward to the mucous membrane of the nose and frontal sinuses, and partly to the conjunctiva and Eustachian tube, then downward into the larynx, then from the throat into the stomach and intestinal canal. This affection consisted essentially of dryness of the parts, for example, dryness of the whitely coated tongue, pasty taste, diminished appetite, desire for liquids without thirst, scraping in the throat, difficulty of swallowing, hoarseness, difficult speech, sneezing, nausea, inclination to vomit, pressure in the stomach, diminished stools, increased gas in the intestines. As objective symptoms, there were dark redness and swelling of the mucous membrane as far as could be seen. A second sphere of action of Belladonna seemed to be the brain. The symptoms consisted of vertigo, pressing and aching pain in the head, reeling and slight stupefaction, sleepiness; the sleep, however, was restless and disturbed by vivid dreams. There were general prostration, general ill-humor, and disinclination to mental work. Dulness and confusion of the head lasted a long time. Of the two extracts, the alcoholic and the aqueous acted in a greater degree upon the brain than the extract ot the Austrian Pharmacopoeia, with the former it was especially noticed that with the increase of the symptoms of the mouth and lances the head symptoms diminished. There was noticed an antagonism between the two preparations. The disturbance of vision began with a slight degree of weakness and fogginess, sensitiveness to light, and progressed to illusions of vision, flickering and visions of colors, a feeling of pressure in the eyeball, increasing to a high degree of weakness of vision, with injection of the conjunctiva, increased lachrymation and dilated pupils. From the external application of the above mentioned, the symptoms were more pronounced ; the pupils were extremely dilated, the iris less sensitive, and the eye turned upward and outward. Especially interesting was the action of Belladonna upon the urinary organs. Without calling particular attention to the nocturnal erections, produced by the smaller doses, there was noticed relaxation of the urinary organs in such away, that there was frequent desire to urinate, with inability to pass urine except by great pressure, and then only guttatim. The action of Belladonna on the skin was increased warmth, amounting even to glowing heat of the face, turgor, and a very deep-red color, even a cherry red. ^ In one person, 4^ grains of the Austrian extract caused red circumscribed spots on the face. In the vascular system in general there was a feeling of chilliness, coldness of the extremities, alternating with heat and increased transpiration, accelerated pulse, and palpitation,'*®®.