Angustura

For many years, a false, very poisonous bark has been sold in the place of the real Angustura, without any one knowing the tree from which that bark came. This tree is now supposed to be the Brucea ferroginea. The bark of this tree is said to furnish the same alkaloid as Nux vomica, Ignatia, etc.

The real Angustura possesses, likewise, great medicinal powers. Although we, obtain that bark from the tree called Bonplandii trifoliata, which is found on St.Thomas del Angustura, in South America, nevertheless, this drug, when improperly administered, may do great injury. In a document furnished by F. A. G. Emmert (see Hufeland's Jour. 1815, Ang. p. 75), we find the following case of poisoning, where three spoonfuls of five ounces of the bark of the spurious Angustura, having been reduced by inspissation to a mass of five ounces in weight, were given to a boy of five years and a half, and produced his death under the following horrible symptoms :

Trembling, which was soon changed to violent spasms, (a. half an h.)

On feeling the pulse, tetanus ensued suddenly.

The eyelids were wide open.

The eyes were staring, immovable, and protruded from their sockets.

Lockjaw ; the lips being wide open, so that the anterior teeth were quite exposed.

Tension of the different muscles of the face.

The extremities were stretched to the highest degree ; they were stiff and rigid.

Violent opisthotonos.

The trunk experienced from time to time violent convulsions, extending along the back, and resembling electric shocks ; it was somewhat raised by those shocks.

Cheeks and lips became blue.

Breathing became intermittent.

At the termination of the paroxysm, which lasted six minutes, the boy breathed with great difficulty, snorting, cheeks and lips being blue.

Great and frequent desire for coffee.

Tetanus was brought on by merely swallowing tepid water.

The pulse was at 102, spasmodic, irregular.

Tetanus either returned of itself, or was brought on by a noise, or by touching some part of the body ; the boy screamed constantly for fear lest some one should touch him.

After the tetanic fit, the eyes were closed ; forehead and face were covered with sweat — cheeks and lips being blue — groaning, without any distinctly indicated pain.

All the muscles lost their tonicity ; the eye lost its lustre ; breathing was convulsive and interrupted by great pauses.

Death ensued after an hour.

Half an hour after death, the body was stiff and rigid.

Twenty-four hours after death, the smell of corruption set in, internally and externally ; the veins contained liquid blood of the color of brown cherries.

The right lung was pale externally, and bloated ; it was full of blood internally ; the left lung was blue externally; it looked blackish when cut, and was filled with blood.

Rigidity of all the muscles of the body, as in tetanus ; one of them suddenly fell to the ground, with consciousness.

Lockjaw.

The following series exhibits similar symptoms in a much inferior degree.

Black coffee is an antidote against its too powerful effects.

According to Noack and Trinks, Angustura has a great action upon the motor and spinal nerves. It has been employed with success in rheumatism with paralytic conditions ; in lockjaw with convulsions of the muscles of the back ; in irritation of the spine, and in affections of the mucous membrane. It is also -proposed against ischias postica.

Analogous Remedies : Ang. spur. Bruc. Cocc. Colch. Nux vom. Plat. — 2 Canth. Carb. an.

Head p. 39

Vertigo in the open air. (a. 20 h.) Obtusion of the head ; slight pullings in the forehead. In the open air she was attacked with a little headache and heat, (towards evening.) Cramp-like headache.

5. Headache ; pressure in the forehead, over both eyes, as if the contents would issue forth, both when at rest and in motion. Headache : Pressure in the occiput, in the afternoon. The brain in the forehead feels as if it were bruised ; this symptom is increased by stooping, and diminished in the open air, (immediately.) Boring headache in the temples. A stitch as from electricity, starting from the temples upwards and downwards.

10. He is attacked with a feeling of vertigo, when crossing a running water, or walking by the side of a ditch full of water ; he fears lest he should sink down. Gloominess and dullness of the head, as after a previous intoxication. Obtusion and sense of contraction of the head, when walking rapidly. Suddenly, great obtusion of the head, as of a skin drawn over the brain, half an hour. (a. J- h.)

15. Great absence of mind ; when occupied with something serious, his attention is constantly arrested by other things, (a. 45 h.) Sometimes he is lost in revery, and even complete absence of thought ; he easily falls asleep when reading. For the first three afternoons, the body feels warm ; on the third afternoon, he experiences moreover an extreme liveliness, and has a quick memory ; however, he is not able to think of any thing with attention, being prevented by the intrusion upon his mind, of a rather agreeable project which he almost believes to be real and feasible, and which exclusively absorbs all his attention ; it is a sort of vivid, waking dream, (a. 4 d.) In the afternoon, great animation and facility of intellect ; he comprehends every thing much more easily than on the first day, and more easily than formerly ; but he feels unable to dwell upon his subject, owing to some internal uneasiness, such as is experienced by those who anticipate some great pleasure, or also owing to all sorts of plans crowding: upon his mind, (a. 35 h.) Early, after rising, great heaviness in the forehead, without any confusion in the head. (a. 3 d.)

15. Pressure in the left hemisphere when stooping ; this pressure abates when raising the head again, (immediately.) Pressure in the temples, (a. 1 h.) Headache in the forehead, towards evening, with great heat in the face. Headache only occurred when there was heat in the face. Headache always occurs towards evening, and continues until the moment one falls asleep.

20. Headache, as if every thing in the brain were moving about, with oppressive and boring pain, especially in the temples ; when laying the forehead upon the table, he feels in the first moments nothing except some tension ; soon, however, the pains return less, violent, and assume their original violence as soon as the head is raised, (a. 12 h.) Pressure in the forehead. Drawing and oppressive pain in the temporal region. In the evening, drawing and oppressive headache on the right side of the head, with pressure on the lower jaw. (a. 1(3 h.) Tearing headache, rather externally, extending from the vertex over the temples, (a. 24 h.)

25. Intermittent prickings in the right temporal region, more externally, (a. 4 h.) Continual itching stitches in the forehead and temple, externally, which do not go off by rubbing. Twitchings at a small place, under the skin of the left parietal bone ; when pressing upon the place, it pains as if it were bruised, (a. 1 h.)

Eyes p. 40

Slight twitchings in the eyebrows while reading. A few stitches over the eyes.

30. Violent burning in the inner half of the eyes themselves, and in the internal corner of the same. Tension, first in one, then in the other eye ; it seems to be directed from behind forwards, early in the morning, (a. 48 h.) There seems to be a feeble vapor before the eyes, which soon passes off. Soreness of the eyelids. Feeling of dryness under the upper eyelids.

35. Pressure in both eyes as if a bright light were irritating them, and as if they became weary. The eyes are red, and burn ; in the morning they seem to be agglutinated. Contraction of the pupils, (a. "3 | h.) Dilatation of the pupils, (a. 13 h.) Pressure on the right eye and the orbit, in the evening, (a. 14 h.)

40. Itching stitches in the upper eyelid, which cannot be removed by rubbing. (a. 1 h.) Early, on rising, dimness before the eyes, as if tire cornea were obscured, (a. 24 h.) He sees much farther and more sharply than usual.1 Far-sightedness ; he saw distinctly objects at a distance, whereas he generally was shortsighted, (a. 2 i h.)2

Ears p. 41

Stitches in the meatus auditorius externus.

45. Burning in the internal ear, in the region of the tympanum. Sensation as if something had got before the ear, and as if something were inserted in it. Cramp in the external ear. Heat in the lobules. Throbbing pain behind the ears, on the side of the neck, as if the carotid were beating.

50. Heat of the ears and both cheeks. Cramp-like pain at the jugum. (a. -J- h.) Hearing is much more acute than usual. (a. 5 \ h.) (Curative reaction of the organism.) Tingling in the ear. (a. 33 h.) Tearing twitchings before the left ear. (a. 1 h.)

55. Several alternate drawings in both ears, which soon go off. Very painful, tearing twitchings in the internal ear of the right side ; they gradually assume the form of stitches, (a. 1 h.) Tearing in a tumor over the right mastoid process. (a- i h.)

Face p. 41

The temporal muscles feel pithy, numb, as if something were pressing out there. Tensive pain in the temporal muscles, when opening the jaws.

60. Pain in the masseter muscles, as if one had fatigued them by masticating too much. Cramp-like pain near the articulation of the jaw. in the muscles performing the office of mastication, especially when at rest ; the pain is diminished by opening or closing the jaws. Feeling of heat in both cheeks, without any warmth being felt externally. Sensation of a corrosive soreness deep in the nose, (immediately.) (Grinding pain in the lower jaw.) (a. 18 h.)

65. In the evening, hot feeling in the cheeks, which, however, do not feel warm when touched, (a. 12 h.)

Jaws and teeth p. 41

Great dryness of mouth and lips, without any thirst, (a. 3 h.) Slight traction in some of the upper molar teeth, which, however, cannot be pointed out with precision. Drawing pain in the two upper incisores of the right side. Drawing pain, which, to judge according to the feeling-. is between the crowns of the middle, upper, right molar teeth. and may be palliated by touching the teeth with the cold finger, (a. 1 h.)

70. Throbbing toothache in a hollow tooth, in the evening, after lying down. (a. 14 h.) Lancinating traction in the gums of the right upper row. (a. 3h.) Gastric symptoms. (Taste in the mouth as of peach-stones.) (Bread tastes sour to her.) He has no desire for drink ; nevertheless, he craves warm drinks more than cold ones ; he did not feel any chilliness after the cold drinks.

75. Nausea during a walk, as if he would faint, accompanied by great lassitude all over, which did not abate by sitting down ; afterwards he felt as if the nausea rose into his head, and he felt hungry. A great many empty eructations after a meal. Bilious eructations. Pinching stitches in the tip of the tongue, which are extremely painful even when the tongue is not moved, (a. 6 h.)

80. Burning as of pepper on the left side of the tongue, almost on its border, (a. 3 h.) White tongue with a feeling of roughness, (a. 12 h.) Roughness and dryness in the back part of the palate and fauces, without any thirst, worse when swallowing, (a 25 h.) The voice is louder and firmer. (Curative reaction of the organism.) (a. 5-^-h.) Bitter taste in the mouth produced by smoking, (to which he is otherwise accustomed.)

85. Putrid, flat taste in the mouth, for a short time. (a. 2 h.) Bitter taste in the mouth, and several slight eructations after dinner, which he ate with a good appetite, (a. 30 h.) Great desire for cold drink, (a. 15 h.) Frequent hiccough, (a. 3 h.) Nausea, especially during a meal.

90. Sense of nausea in the stomach, (a. 1 h.) In the evening, during a slumber, his mouth had become filled with a viscid, insipid and putrid phlegm, he could not drink enough. Although his appetite is very great, yet he does not relish his nourishment ; he feels as if it were offensive to him ; at the same time he experiences a fulness in the chest, owing to suppressed eructations ; he feels unable to satisfy his appetite by eating a copious dinner, (a. 6h.)

Stomach p. 42

In the beginning of the meal, cutting pain in the stomach, like soreness ; it went off during the meal. (a. 3 d.) Cramp-like pinching pain below the pit of the stomach, in the evening, when sitting, (a. 13 h.)

95. Cutting tearing in the pit, increased by moving the trunk, after dinner.

Abdomen p. 42

Loud rumbling in the abdomen. Stitches in the abdomen, followed by a sense as of drawing. Early in the morning, diarrhoea comes on after previous colic, and nausea ; the last evacuation was mere slime. Colic and diarrhoea ; the last evacuation was mere slime, (a. 12, 84 h.)

100. (Tingling itching of the rectum, as of ascarides.) Cutting under the short ribs, in the right side of the abdomen, when moving the trunk, (a. 48 h.) Dull, shaking, erratic shootings in the left side of the abdomen. Dull stitches in the abdomen, on the left side, near the navel, (a. 24 h.) Cutting pain in the left lumbar region from within outwards, (a. 3 h.)

105. Cutting in the hypogastrium, transversely over the ossa pubis, accompanied by pressure towards the rectum, (a. -J- h.) Cramplike colic when walking. Pinching in the right lumbar region when at rest. Drawing pain as from a bruise, in the light side of the abdomen, when walking in the open air. (a. 1 h.) Pressure in the hypogastrium from within outward, accompanied by anguish, (a. 16 h.)

120. Cramp-like pressure over the ossa pubis, when sitting, as if something were boring out there. (a. 12 h.) Audible rumbling in the abdomen, with eructations. Fermenting and rumbling in the abdomen, as if diarrhoea would come on, accompanied by incarceration of flatulence, (a. 3 h.) Cutting and gurgling in the hypogastrium, transversely over the ossa pubis, when taking warm milk. (a. fh.) Painless motions, grumbling and gurgling in the intestines, continuing almost unceasingly for three hours.

Stool p. 43

125. Indications of diarrhoea, with dragging through all the intestines, (a. 2 h.) Several times a sensation in the intestines as if diarrhoea would come on. Frequent desire in the rectum, as if diarrhoea would come on immediately, with shiverings over the face. Every evacuation is followed by shiverings over the face, and goose-skin. The stool was not as thin as might have been expected, according to the existing indications of diarrhoea.

130. Sensation as if stool had not been passed sufficiently, and as if more would come. Sensation in the rectum as if it would protrude ; this symptom is followed by a yellow, soft, very profuse evacuation, (a. 1 ± h.) Three very thin stools in the space of four hours. Thin, copious stool without any pain. (a. 2 h.) Emission of stinking flatulence.

135. During a soft stool, there was painful tenesmus of the rectum, as if it had been contracted, with distention of the haemorrhoidal veins, and a burning pain as if the rectum were being corroded, (a. 2d.) Moderate costiveness. Frequently, slight desire for stool ; he felt as if stool would not take place ; upon straining, a few hard clots came out. (a. 12 h.)

Urinary organs p. 43

Frequent desire to urinate, with but little urine being emitted, (a. 2 h.) Tenesmus of the bladder, followed by the emission of a quantity of white urine ; tenesmus after micturition, (a. 36 h.)

140. Orange-colored urine, which becomes easily turbid, (a. 24 h.) Burning after micturition ; one is frequently obliged to urinate, although but a few drops are emitted each time ; they cause a burning at every flow.)

Genital organs p. 43

Itching of the scrotum. Stiches, sometimes itching of the prepuce. Voluptuous itching of the tip of the glans, which forces one to rub ; it occurs when walking in the open air. (a. 6} h. — 145.) Traction in the left spermatic cord alternating with twitches, accompanied by a sensation of shivering in the neighboring parts of the scrotum and thigh.

Throat p. 43

Stitch in the epiglottis.- Hoarseness, which is occasioned by much phlegm in the throat, (a. 10 h.) Titillation in the larynx, inducing a dry, short, and hacking cough, and continuing for a long time. (a. 2f h.) A short and hacking cough the whole day, owing to a titillation in the larynx accompanied by a rattling in the chest, when walking in the open air, and by the expectoration of much yellow mucus.

160. Violent cough, deep from the trachea, early in the morning, accompanied by the expectoration of yellow mucus, (a. 24 h.) Roughness in the throat ; he has retching without being able to throw up anything, (a. 6 h.) Tenacious phlegm in the trachea, which is difficult to hawk up. (a. 10, 11 h.)

Chest p. 44

Cutting -pressure in both sides of the chest, first only during an expiration ; afterwards the pressure is changed to cutting thrusts, continuing even when the breathing is arrested, (a. 1 h.) Tightness of the chest, and pressure in the left side of the chest, when walking fast. (a. 12 h.)

165. Spasm in the chest, as is experienced when one is suddenly assailed by a violent coldness. Pressure across the whole right side of the chest and abdomen, as if these parts were being compressed in front and behind, accompanied by incisive cutting, downwards, in the sternum, and in the dorsal spine, increased by inspiration and every movement of the trunk, (a. 5. h.) Great oppression of, and pressure upon the chest, accompanied by pressure on the ' sides of the frontal bone, and violent palpitation of the heart, (towards evening, when ascending the stairs.) (a. 2 h.) Cutting thrusts in the sternum, and the dorsal spine, from without inwards, (a. 36 h.) Violent palpitation of the heart, when siting or stooping, accompanied by a painful sensation, as if the heart were contracted.

170. Violent palpitation of the heart, in the evening, when lying in bed ; it decreases when sitting up. Painful thrust in the region of the heart. When making as deep an inspiration as possible, it seems to be arrested under the upper portion of the sternum ; he there feels a pain like a dull still stitch or pressure, (a. 72 h.) Sense as of trembling, internally, resembling hiccough, during an inspiration ; the inspiration seems to be divided into two jerks from within outwards, (a. 8. h.) Cutting pressure through the thoracic cavity from within outwards, accompanied by a sense of anguish, (a. \ h.)

175. Single stitches in the sternum, when sitting, (a. 28 h.) Painful sensitiveness of the chest, even when he touches it only feebly, (a. 24 h.) Pressure on the chest, towards the axilla, and on the tendon of the pectoralis major, (a. 3 d.) Itching stitches, in front, in the last true rib of the right side, which, in the beginning, do not pass off by scratching, but afterwards disappear of themselves, (a. 24 h.) Recipient, short cough, followed by one hiccough, like eructation.

180. Quickly passing tightness of the chest, (immediately.) When moving about in the bed, she feels a pain in the muscles of the chest, early in the morning ; the arms, when laid near each other, are painful, by day ; she may touch the parts without feeling any pain, not even when breathing. Sharply pressing, almost pinching pain, at a small place, in the upper portion of the chest, (a. 15 h.) Cutting stitches in the last rib, during an inspiration, and moreover before going to bed, and after having laid down.

Back p. 45

Early in the morning, when in bed, pain in the small of the back, as if every thing were broken ; after having risen from the bed, she was unable to pick up any thing from the floor, before several hours had elapsed ; this symptom was followed by hunger, afterwards cutting pains in the abdomen, and loose stools, which, finally, became slimy.

185. Squeezing pressure in the small of the back, as if the parts had been bruised by blows ; this pain often roused her from sleep ; the pain was worst at four oclock in the morning, but it had disappeared when she rose. Stitches below, and by the side of the small of the back, when sitting. Sense as of a dull gurgling in the small of the os sacrum, (a. 1 h.) Pain in the small of the back, rather on one side, as if the parts had been bruised ; the pain was drawing and pressive, and was experienced when sitting, (a. 35 h.) At night, when in bed, he frequently feels a stitch on the right side near the dorsal spine, between the scapulae ; the stitch is felt during motion, and appears to penetrate deep into the chest

190. Tension in the muscles of the back, near the axilla ; he finds it difficult to lift up his arm, (immediately.)

Neck p. 45

Pretty, violent regulations in the muscles of the neck, on the left side. (a. 2 h.( Tension, in front, on the right side of the neck, accompanied by sharp stitches ; this symptom is felt even when at rest. (a. 3 h.) Dull stitches between the top of the left shoulder and the neck. Painful stiffness, like traction, between the scapulae and in the nape of the neck, early in the morning, when in bed ; when rising, she was unable to move her arms on account of the pain, nor was she able to turn her neck, the whole forenoon ; this symptom occurred several mornings in succession, lasting until noon, accompanied by faintishness of the whole body

195. Pain as from bruises, in the muscles of the neck, on the left side, towards the shoulder ; the parts felt as if they had been . strained too much ; this symptom only occurred during motion, and abated in the open air. Cutting stitches in the scapula. Drawing stitch in the nape of the neck.

• Superior Extremities : Painful twitchings in the top of the shoulder. Upon extending the arm for a long time, the arm feels as if one had held a heavy weight in one's hand for a long time ; it is a sort of paralysis. Stiffness in the joints of the elbows, accompanied by lassitude of the fore-arms. Pain in the elbow-joint, apparently in the tendons of the muscles, as if he had knocked them against something ; this pain increases by moving the arm or leaning upon it (after walking in the open air.) (a. 24 h.)

200. Traction in. the fore-arm and in the hand, like a cramp. Traction in one of the fingers of the left hand. Pain in the middle finger of the right hand, as if it were torn out. Pain in the posterior joints of the fingers, such as is felt when moving an ulcerated part. The ring-finger feels insensible, numb, pithy, and as if it had died off.

205. Pressive cutting in the axilla, (a. f h.) Aching of the humerus, as from a bruise, (a. If h.) The left arm feels heavy, when one is walking, with pressure on the outside, in the region of the elbow-joint, as if the arm were being pulled down when left hanging, (a. 4 h.) Fine itching of the arms, which passes off by rubbing, (a. 1 h.) Fine tearing in the arms, apparently more in the bones, and worse when at rest than in motion, (a. 2 h.)

210. Single, deeply penetrating stitches over the left wrist-joint, (a. 7 h.) Feeling of heat on the dorsum of the left hand. (a. 6 h.) Rheumatic drawing pressure upon the dorsum of the right hand, in the evening. Dull stitches in the dorsum of the right hand, in front of the wrist-joint, (a. £ h.) The fingers of the right hand are cold to the touch, and they feel cold inwardly, (a. 3 h.)

215. Aching, internally, in the flesh of the ball of the left thumb, (a. -J- h.) Traction around the joint of the thumb, as if it were sprained, especially when bending the thumb.

Lower extremities p. 46

The whole right side of the abdomen, and of the thigh and leg, feels bruised as if by blows, and, when walking, threatens to fall in on account of a rheumatic drawing pain. (a. 1-^ h.) Sudden heaviness and lassitude in the lower extremities, (a. | h.) Cramp-like pain at the upper border of the ilia, extending as far as the dorsal spine, (a. 12 h.)

220. Dull stitches in the left os innominatum, close behind the hip-joint ; the stitches occur in short paroxyms, and are increased by every motion. The upper part of the hip-joint feels painful, as if it were luxated ; it is almost unfit for walking. Boring, paralytic pain in the region of the ischiatic nerve, on the back part of the thigh. Pressive, drawing pain in the tendons of the hip-joints, upon rising from a seat. (a. 7 h.) Fine shootings in the skin of the glutei muscles, accompanied by tingling, externally.

225. Sharp stitches in the anterior muscles of the right thigh. Tremulous stitches in the left thigh, and in the upper border of the ilium, extremely painful, and felt only when sitting, (a. \ h.) When bending the knee, one feels a tensive pain in the anterior muscles of the right thigh. The anterior muscles of the right thigh feel paralyzed ; he feels a painful tension when moving the muscles. Fine tearing in the thighs, apparently more in the bones ; it is worse when at rest, than in motion, (a. 2 h.)

230. Drawing aching on the external side of the thighs when walking. Cramp-like pain in the middle of the posterior surface of the thigh, only when walking, (a. 21 h.) Tensive ache in the upper and anterior portion of the rectus muscle of the thigh, when stretching the part. (a. 2-*- h.) Fine itching of the thigh, which goes off by rubbing, (a. 1 h.) He cannot walk fast ; his legs feel too stiff.

235. Ascending stitches in the external tendons of the knee, when walking in the open air. (a. 13 h.) Intermittent prickings in the left patella, when walking in the open air. (a. 6 h.) Cramp-like, straining traction from below upwards, in the calf, and also in the thighs, extending upwards from the bend of the knee. Tense paralysis, as if produced by a contraction of the ligaments, from the middle of the bend of the knee, as far as the calf, both when at rest and in motion, (a. \ h.) When crossing the legs, he feels a cramp-like tearing traction in the heel of the left foot, which is standing still, and a pressive drawing in the knee of the other leg, which is laid across, (a. 10 h.)

240. When walking, he feels a drawing, superficial, softly pressive pain at the tibia, and around the joint of the foot, accompanied by a sensation as if the tibia would break, which prevents him from walking. Dull stitches in the left tibia, (a. 1 h.) Burning at the tibiae, when walking. Pressure and traction in the tibia, in the evening, when sitting, (a. 12 h.) Early in the morning, when walking about, she feels a drawing and aching in the joints of the feet, with heat in the joints, and a sensation as if they were luxated ; this symptom is felt in the parts near the malleolus externus. (a. 3 d.)-*-245. Aching as from a sprain, in the right foot, when walking in the open air. (a. 2± h.) Paralysis of the joints of the feet. Dull drawing stitches in the joint of the right foot, when sitting, (a. 11 h.) Feeling as of burning, around the external malleolus of the right foot, when walking or sitting, (a. 26 h.) Almost lancinating tearing on the dorsum of the left foot, mostly when moving the parts.

250. Cramplike, pressive traction on the border of the left foot, on the prominence of the fifth metatarsal bone, as if he had sprained the joint by stepping wrong, (a. 5 h.) The external border of the loot, and the part below the external malleolus go to sleep, when walking. Stitches in the heel, when sitting, in the even ing. Sudden tearing in the sole of the foot, when sitting. Sweat of the feet

255. Sense as of drawing and clawing in the pelvis, when walking. During exercise, one frequently feels a pain in the hip, as if it were stiff or luxated, almost like cramp. Faintishness of the lower extremities, which is especially felt above the knee-joint, as after a distant journey. Sense as of drawing and clawing in the right knee-joint when walking or when standing upon the foot stretched forward. Sense as of stiffness in the feet (lower extremities) almost as if the contact with a consumptive individual had deprived him of all strength.

260. Traction in the tibia and the neighboring muscles. The feet feel numb and pithy, as far as the knees, but without any tingling. Momentary cramps in the feet. Cramp-like pain in the anterior part of the foot, without any real contraction of muscles, more when sitting or at rest. (a. ., h.) Pain of the foot, when standing upon it.

265. Cramp-like pain in the foot, followed by an aching on the day following, and a feeling, when standing upon the foot, as if it had been bruised by blows.

General symptoms p. 48

Cracking in almost all the joints, but it is not audible. Itching, in the evening, when in bed ; after rubbing the parts, flat, very painful ulcers make their appearance.

Fainting fits, weakness, paralysis p. 48

Sensation in the whole body as if he had lost his strength, and as if the marrow of the bones had become stiffer and coagulated, (immediately.) One feels excessively tired after walking in the open air, especially in the thighs.

275. Lassitude and weariness of all the limbs, without any sleepiness. When walking, he feels a painful straining in the muscles, here and there. In the evening, after having sat for an hour, he feels quite stiff and contracted ; after rising from his seat he is unable to right himself, (a. 13 h.) Paralytic weakness in the hands and elbow-joints ; he wa% scarcely able to move them, without, however, feeling any stiffness, and without, otherwise, any obstacle, accompanied by chilliness and want of animal heat, (a 1 h.) Cracking in all the joints, (a. 26 h.)

280. Greatly excited and extravagant mirth, accompanied by traction in the limbs, as if the tendons were strained, in the afternoon, (a. 2 d.)

Sleep p. 48

He feels pretty cheerful and lively, when he performs no intellectual labor ; but he becomes dizzy when reading something ; he then falls asleep immediately. Uneasiness, early in the morning, frequent yawning and want of disposition for any kind of work. (a. 4 d.) When sitting and reading, he falls asleep, but is roused up by the slightest noise, and starts up with a great chill which thrills through and through his body. Frequent yawning, with extension and stretching of the limbs, (a. 24 h.)

285. In the evening, great physical depression, and irresistible inclination to sleep while sitting ; he sleeps one hour, with snoring, but afterwards, on lying down, he cannot fall asleep under an hour. Great sleejmiess in the evening, until nine oclock, afterwards one is wide awake until after midnight. His sleep is interrupted by dreams until six oclock in the morning ; then he became wide awake, afterwards fell asleep again, and then remained sleepy until noon. Sleep, towards morning, with dreams. Vivid dreams, which were partly disagreeable, partly causing anxiety ; he frequently woke up ; when he had fallen asleep again, he always dreamed of something else.

290. Uneasy sleep ; uneasy sleep at night, which came on only towards morning ; full of dreams. Uneasy sleep, full of dreams ; he did not wake up, however, and had pollutions two nights in succession. Confused dreams, partly of a terrific nature. Frequent attacks of yawning, without any sleepiness, with a cramp-like pain in the jaws.

295. Inclination to constant stretching. Uneasy sleep ; she often wakes up, without any cause.

Fever p. 49

Early in the morning, chilliness in the bed, without any subsequent heat. Internal shivering at three oclock in the afternoon, with violent thirst, without any subsequent heat, several days in succession. At three oclock in. the afternoon, one feels a shivering, with goose-skin, abating in the open air, without any thirst, for several days in succession.

300. Slight heat after the chill. Increasing warmth over the whole body, towards evening. Heat around the head, with sweat upon the forehead, early, when in bed. Heat, in the night, especially around the forehead, so (hat she is unable to sleep again after three oclock in the morning ; at nine oclock in the forenoon, she experiences a chill. Violent chills over the back, when walking in the room, in the forenoon, (a. 25 h.)

305. A good deal of thirst, in the forenoon ; in an hour afterwards, chills, over the back. Increased warmth of the cheeks and the body, accompanied by aching in the temples and the sides of the forehead. Internal and external heat of the face, immediately after supper. In the afternoon, feeling of warmth in the whole body, especially the cheeks, not without thirst, (a. 2 d.) Warmth of the whole body, towards evening, with pressive traction in the side of the forehead, and accompanied by thirst, (a. 4 d.)— 310.

Notes p. 40

1 Note: Reaction of the organism. 2 Reaction of the organism.