Chininum Arsenicosum

Arseniate of Quinine. 2 C20 -^24 -^2^2- ^^ -^3- 4 ^2^-

Until proved by the Philadelphia Clinical Society, at the instigation of Dr. William H. Biegler, who cured with it a case of scrofulous ophthalmia, the only proving we had was the short one by Dr. Mur, contained in Allen's Encyclopedia, v. 3, here designated No. 6. The provers of the Clinical Society are: 1. Dr. W. B. Trites, 2d dec. trit.; 2. Mr. J. J. Surges, 1st dec. trit. ; 3. Mr. E. W. Le Roy, 6th dec. trit. (both under supervision of Dr. C. Mohr) ; 4. Dr, C. B. Knorr, 30th cent., and 6. Mr. Walter K. Fulness (under supervision of Dr. Knorr) 2d dec. trit. Clinical Authorities. — Intermittent hemicrania, Altschul., Ruck. Kl. Erf., V. 5, p. 82; Headache, D. F. and J. C. Moore, N. E. Med. Gaz., 1869, v. 4, p. 446; Occipito-cervico intercostal neuralgia, Par, Ham. Klink., 1869, p. 19 ; Rheumatic headache, H. G. Bojanus, Eaue's E., 1874, p. 257 ; Scrofulous ophthalmia and keratitis superficialis, Wm. H. Biegler (unpublished); Malignant angina in scarlatina, Kafka's Therapie, 1, p. 433: Diphtheritis, numerous cases, Findeisen, A. H. Z., v. 87, p. 113 and 196 ; Diphtheria, A. Neuschsefer, A. H. Z., v. 78, 1869; Intermitting diarrhoea, Kafka, Eiick. Kl. Erf., v. 5, p. 410; Suffocative attacks in tuberculosis, Kafka, Eiick. Kl. Erf., v. 5, p. 797; Epileptiform spasms, Par, Ham. Klinik, 1869, p. 2 ; Inter,ittent fever, S. E. Geiser, Cin. Med. Adv., v. 4, p. 79.

Mind

Depressed in spirit, with dulness of mind^.

Listless after previous fever; no desire to do anything^.

Desire to sit or lie in one place and not be disturbed^.

Mental dulness, with inclination to vomit^.

▌ Anxiety and nightly delirium. θ Diphtheria.

The chilly waves are brought on by thinking of them 2.

▌ Anxiety, with dyspnoea. θ Tuberculosis.

Greatest anxiety, with unquenchable thirst; must sit up bent forward, if possible at open window. ^/Tuberculosis.

▌ Child sits up in bed lamenting. θ Keratitis.

│▌ He believes he cannot long endure such utter prostration. θ Epilepsy.

▌ Irritable mood precedes the headache, which is < by mental and bodily exercise. θ Hemicrania.

▌ In consequence of fright, 1. sided hemicrania.

│ Sensorium. ▌Confused feeling in head. θ Diphtheria.

Inner Head

▌ Severe, darting, tortuous pains running up into head and preventing sleep.

▌ Without previous aura he feels it rushing like lightning through brain and down r. side of neck into arm, which is distorted and wrenched so as to crack audibly; the

facial muscles are convulsively drawn, sight and speech cease, consciousness ' leaves, and he falls to the ground ;

the attack is followed by cold sweat, loud eructations and a feeling of utter prostration. θ Epileptiform spasms.

Confused headache i. .

Frontal and occipital headache^.

Headache affecting occipital protuberance^.

Dull headache in frontal region, not relieved by eating.^

Neuralgic pain in r. temple and above eye, lasting several days, with inclination to move the skin over the aching place with his hand^.

▌ Tearing, boring pain in 1. side of head, affecting the eye, with flickering, pain and lachrymation; ringing in ears, nausea and vomiting during the attack, which regularly appears at midnight; is subject to furuncles and abscesses which relieve the head.

Outer Head p. 57

Burning pain in 1. occipital protuberance, extending down nape of neck, along shoulder-blade and over I: half of thorax, producing orthopnoea; the attack commences with stretching and yawning and a shaking chill, generally in the morning, and lasts until after midnight.

Bruised feeling all over head after fever and sleep 2.

Neuralgic pain about head, particularly in temples ; < in 1. side; > by rubbing the aching spots*.

Slight painful pressure in forehead and temples^.

Slight sudden throbbing of temporal arteries after 1 p.m.

Sight and Eyes p. 57

▌ Intense photophobia and spasms of orbicularis muscles, gushing hot tears, large ulcers attacking each eye, aggravation from midnight until 3 a.m., during which time the child sat up in bed lamenting. θ Keratitis.

▌ Scrofulous ophthalmia; < after 1 a.m.

▌ Flickering before 1. eye, with pain and lachrymation. 6'Hemicrania.

Hearing and Ears p. 57

▌ Ringing in ears. θ Hemicrania.

Smell and Nose p. 57

Watery discharge from nose''^.

Constant running of profuse limpid and watery discharge^.

Yellow discharge from nose^.

Left nostril fills up when lying on that side 2.

Nostrils stop up, particularly left, on lying down, preventing breathing through nose^.

Nose clearer when prover is in an erect posture and out of doors^.

Sneezing, < sore throat^.

Profuse discharge from both nostrils 2.

▌ Nose stopped up with purulent and bloody substance. θ Diphtheria.

▌ Corners of nose excoriated. θ Diphtheria.

Upper Face p. 58

▌ Face pale, sallow and bloated. θ Intermittent fever.

Lower Face p. 58

▌ Swelling of submaxillary and parotid glands. θ Diphtheria.

▌ Blueness of lips. θ Tuberculosis.

Taste and Tongue p. 58

Sweetish taste after clearing throat and coughing 2.

Yellow slimy coating on tongue, with bitter taste ^.

Soreness and redness of tip of tongue^.

Metallic bitter taste in mouth^.

▌ Tongue coated thick and brown. θ Diphtheria.

Inner Mouth p. 58

Burning canker spot inside of 1. upper lip^.

▌ Foetor oris. θ Diphtheritis. θ Scarlatina.

Throat p. 58

Post nasal catarrh; < on 1. side^.

▌ Diphtheria, diffused blackish exudation, hoarseness, great prostration, confusion in head, nightly delirium, difficult swallowing, fetid stench from mouth, dry tongue, dry skin, pulse 130, fever assuming- a putrid type^.

Constant hacking and clearing of throat^.

Throat feels sore and inflamed, with a good deal of cough^.

Throat feels raw and sore; < by coughing and sneezing^.

▌ Malignant angina during scarlatina, with paleness of skin, quick exhaustion and rapid destruction of mucous membrane of fauces.

▌ Diphtheria: foe tor oris, swelling of submaxillary glands, frequently also of parotids, violent fever and great prostration.

▌ Diphtheria: strong foetor oris; submaxillary glands swollen and painful ; breathing through mouth because nose is stopped up with purulent and bloody substance; corners of nose excoriated; tongue coated thick and brown, both tonsils covered with a grey exudation, on right tonsil a bloody ulcer with uneven edges which corresponded to size of a membrane just retched out; lower half of uvula gangrenous, upper half covered with exudation; posterior wall of fauces completely covered with exudation; swallowing of liquids very difficult; great weakness; sleeplessness; pulse small, very frequent.

Appetite, Thirst. Desires, Aversions p. 58

No appetite for breakfast after fever in the night^.

No thirst with the fever^.

▌ Thirst which cannot be appeased; during attacks of suffocation. (^Tuberculosis.

Eating and Drinking p. 58

'Eggs and fish cause painless diarrhoea at once. θ Rheumatic headache.

▌ She does not like cold water. θ Rheumatic headache.

Water tastes bitter, or has a disagreeable flavor like the water found in cars^.

Hiccough, Belching, Nausea and Vomiting p. 59

Inclination to vomit, with mental dulness^.

Sudden inclination to vomit at 2 p.m., lasting only a few minutes^.

Regurgitation of food*.

Eructations. θ Epilepsy.

▌ Nausea and vomiting, followed by sleep. θ Hemicrania.

Scrobiculum and Stomach p. 59

Sensation from stomach through entire intestinal canal as if diarrhoea would set in*.

Burning, sore feeling in stomach; < on motion, particularly going up stairs*.

Uncomfortable feeling in stomach is > by expanding the chest*.

Burning in stomach*.

Hypochondria p. 59

▌ Left hypochondriac region enlarged. θ Intermittent fever. *

Abdomen p. 59

▌ Abdomen bloated. θ Intermittent fever.

Sore pain in a small spot, which could be covered with tip of a finger below and to right of umbilicus, coming and going, but continuing all day^.

Very severe colic ^.

Pressure in solar plexus, as if he had eaten tough meat or hard nuts, extending towards back where it changes to a pinching sensation, spine painfully sensitive to touch at this point ^.

Stool and Rectum p. 59

Diarrhoea from malarious poisoning ; stools thin, watery, undigested, off"tensive, dark or light brown, sometimes with a meal-like sediment.

From ten to fifteen painless, watery, very offensive stools from 6 to 10 a.m., with burning in anus after each passage; slightly emaciated, pale and weak.

▌ Fetid diarrhoea with pains in bowels. θ Intermittent fever.

Urinary Organs p. 59

▌ Spasmodic retention of urine; > by application of hot cloths to chest, which, however, is followed by syncope. θ Occipito-intercostal neuralgia.

Voice and Larynx. Trachea and Bronchia p. 59

Hoarseness. θ Diphtheria.

Aching in bronchial region; < 1. side*.

▌ Seemed to prevent diphtheritic membrane from spreading to larynx. θ Malignant scarlatina.

Respiration p. 59

Respiration very free as if the thorax were hollow^.

▌ Blueness of lips, hands and nails with attacks of suffocation, which begin in morning and last until noon. θ Tuberculosis.

▌ Must sit bent forward and if possible at an open window during attack of suffocation; < by any other position.

▌ Dyspnoea with anxiety. θ Tuberculosis.

Every forenoon at 9 oclock attacks of suffocating spells.

Cough p. 60

Coughing < sore throat^.

Cough with but little expectoration^.

Slight cough at long intervals, seems to come from full feeling in chest^.

Inner Chest and Lungs p. 60

Senile subacute catarrh with periodical fever, generally < at night.

Peculiar colicky pain in lower part of 1. lung felt like a pain from flatulence, comes and c[uickly passes away, often repeated 1.

Sharp stitch in lower part of r. chest in front; < when inspiring, causing him to cry out^.

Desire to inflate lungs to their fullest extent to relieve uncomfortable feeling in stomach while riding in the open air on a raw cold day^.

The chest feels hollow and respiration freer*.

Limbs icy cold; cold clammy sweat all over; greatest anxiety and unquenchable thirst; must sit up, bent forward if possible, at open window. θ Tuberculosis.

Heart, Pulse and Circulation p. 60

Angina pectoris, with dropsical symptoms, venous hypersemia and cyanosis.

Trembling of heart, with rumbling noise, unable to distinguish ]3pulsations, lasting one hour^.

Palpitation ; noticed on leaning against back ^.

Sensation as if heart had stopped^.

No perception of beating of heart^.

Beat of heart and pulse irregular, numbering 200 per minute^.

Pulse cannot be felt on 1. side^.

Beat of heart becomes regular towards noon^.

Pulse in radial and temporal arteries 200"^.

▌ Pulse small, very frequent. θ Diphtheria.

▌ Pulse 130. θ Diphtheria.

Pulse 98, full and strong during fever^.

Outer Chest p. 60

Paralysis of respiratory muscles on 1. side. θ Intercostal neuralgia.

▌ Violent neuralgic pain in 1. mammary region, as though that part were torn with red hot tongs. θ Intercostal neuralgia.

Aching in intercostal muscles, r. side in locality of sixth and seventh ribs on making inspiration*.

Neck and Back p. 60

Back feels weak as after taking a long journey^.

Pain in muscles between 1. shoulder and neck, as if sprained, on rising from sleep at 4 p.m.*

Upper Limbs p. 61

Painful weariness in shoulder and elbowjoints^.

Aching in biceps of 1. arm^.

Acute fugitive j)ain in 1. olecranon process^.

Pain in flexors of 1. forearm on radial side near elbow^.

Palms of hands hot and dry^.

Sore, aching fugitive pains in first phalanx of 1. thumb, the same, but in a less degree, in right^,

▌ Blueness of hands and nails. θ Tuberculosis.

Lower Limbs p. 61

Weariness of lower extremities.

Gooseflesh on lower extremities, with chillv feeling-2.

Sore, aching fugitive pain in 1. leg near knee^.

Aching, sore pain in anterior lower two-thirds of 1. tibia ^.

Itching on internal malleolus of r. foot at 2 a.m. ; on investigation discovered eruption of bright red pimples^.

Increased tenderness of corn on 1. little toe; had to remove shoe to ease pain"*.

Limbs in General p. 61

Limbs icy cold. θ Tuberculosis.

Rest. Position. Motion p. 61

Desire to sit or lie in one place.

Desire to move skin over aching place in temple with his hand.

Lying : on 1. side, nostril fills up.

Sitting : bent forward > anxiety and suffocation.

Leaning against back : palpitation noticeable.

Erect posture : nose clearer.

Expanding chest : > uncomfortable feeling in stomach.

Motion: and going up stairs < burning soreness in stomach; < intercostal neuralgia.

Bodily exercise : < headache.

Riding in open air : desire to expand lungs to relieve uncomfortable feeling in stomach.

Sneezing: < sore throat; and coughing < rawness in throat.

^"Nerves, l Great j^rost ration. θ Diphtheria.

Lassitude and fatigue*.

Feels as when suffering from partially developed malaria^.

Felt sore and ached all over^.

Felt like one having taken a long journey 2.

▌ Great prostration, followed by a deep sleep after an attack of dyspnoea. θ Tuberculosis.

• I I Epilepsy ; after attack cold pers^iration, eructations, and a feeling of such utter prostration that patient believes he cannot endure it long.

Sleep p. 61

Goes to sleep after tea and sleeps heavily all night*.

▌ Deep sleep after suffocative attacks. θ Tuberculosis.

▌ Awakes from sleep exhausted and bathed in sweat after an attack of dyspnoea. θ Tuberculosis.

Restless until 3 a.m., constantly changing position, particularly as soon as pillow becomes warm^.

Sleep frequently interrupted^.

▌ Sleeplessness. θ Diphtheria.

Time p. 62

Nightly : delirium in diphtheria.

At night: senile subacute catarrh <; sleeps heavily; is more feverish.

From midnight until 3 a.m. : ophthalmia <.

From morning until after midnight: burning pain in head with chills.

At 2 A.M. : itching eruption on internal malleolus of r. foot.

Until 3 A.M. : restless.

At 4 A.M. : sprained feeling in muscles of back.

From morning to noon : suffocation with blueness of lips, hands and nails.

In morning: broken-up feeling after fever, no appetite for breakfast.

6 to 10 A.M. : diarrhoea.

At 9 A.M. : suffocating spells.

Toward noon : beat of heart becomes regular.

Forenoon : chill at irregular hours.

Towards midnight : fever following chilliness, pulse 90.

After 1 P.M.: throbbing of temporal arteries.

At 2 P.M.: sudden inclination to vomit.

After 8.30 p.m.: chilliness with gooseflesh.

Temperature and Weather p. 62

Hot cloths to chest > retention of urine but cause syncope.

Warmth of pillow < restlessness.

Open window : sits there to > anxiety and suffocation.

On a raw, cold day, while riding, desire to expand lungs to relieve uncomfortable feeling in stomach.

Damp weather : is sensitive to it, and feels chilly. θ Rheumatic headache.

Cool part of bed < chilliness.

Inclination to throw off covers and open windows, with fever towards midnight.

Fever p. 62

Chilly feeling like cold waves after 8|- p.m. in bed, with gooseflesh all over body, but particularly on legs^.

Chilliness coming in waves, with restlessness; < by moving hands and feet to a cool part of bed, also by thinking of it^.

▌ Chill always in forenoon, not at a regular hour, however; sometimes once every day, again every other clay ; sometimes paroxysms would close with perspiration, sometimes without; before the attack, headache, yawning and stretching. θ Intermittent fever.

After chilliness, feverish towards midnight, pulse 98, full and strong, with inclination to throw off covers and open windows, no sweat^.

Feverish all the time, but more so at night^.

No sweat after fever, but weak, broken-up feeling in the

morning and no appetite for breakfast^.

▌ Violentfever with great prostration. θ Diphtheria. θ Malignant scarlatina.

Attacks, Periodicity p. 63

Periodically : furuncles and abscesses. θ Hemicrania.

Like cold waves : chilliness in evening.

At long intervals : slight cough from full feeling in chest.

Coming and going quickly : peculiar colicky pain in lower part of 1. lung, often repeated.

Coming and going, all day : sore pain in spot below and to r. of umbilicus.

Lasting a few minutes : inclination to vomit.

Lasting one hour : tremor of heart.

Every day or every other day : chill.

Lasting several days : neuralgia in head.

Locality and Direction p. 63

Left : hemicrania ; boring in side of head, affecting eye ; burning in occipital protuberance, down nape of neck, along shoulder-blade and over half of thorax ; neuralgia about head ; flickering before eye ; nostril fills up when lying on side ; canker spot inside upper lip ; post nasal catarrh < ; hypochondriac region enlarged ; aching in bronchial region ; peculiar colicky pain in lower part of lung ; pulse cannot be felt ; paralysis of rest)iratory muscles ; neuralgia in mammary region ; pain as if sprained between shoulder and neck; aching in biceps; acute pain in olecranon process ; pain in flexors of forearm ; pains in thumb ; pain in leg near knee ; pain in anterior lower two-thirds of tibia ; tender corn on little toe.

Right: rushing like lightning through brain and down side of neck into arm ; neuralgia in temple and above eye ; diphtheritic ulcer on tonsil ; sore pain in small spot to r. of umbilicus; sharp stitch in lower part of chest, in front ; aching in intercostal muscles, locality of sixth and seventh ribs; pains in thumb; itching eruption on internal malleolus of foot.

Sensations p. 63

As if diarrhoea would set in ; as if heart had stopped ; as if torn with red hot tongs in 1. mammary region ; as after a long journey, weakness in back ; as if he had eaten tough meat or hard nuts, in solar plexus ; as when suffering from partially developed malaria.

Pains : in flexors of 1. forearm.

Acute pain : in 1. olecranon process.

Neuralgic pain : in r. temple and above eyes ; about head, particularly in temples ; in 1. mammary region.

Stitch : in lower r. chest.

Darting : running up into head.

Tearing : in 1. side of head and eye.

Boring : in 1. side of head and eye.

Burning: in 1. occipital protuberance to nape of neck, along shoulder-blade and over 1. half of thorax; canker spot in upper lip ; in stomach ; in anus.

Colicky pain : in abdomen ; in lower part of 1. lung.

Raw feeling : in throat.

Sore pain : in a small spot below and to r. of umbilicus.

Sprained pain : in muscles of back between shoulder and neck.

Pinching : back, in region of solar plexus.

Pressure : in forehead and temples ; in solar plexus.

Tenderness: of corn on 1. little toe.

Aching : in bronchial region ; iii intercostal muscles r. side ; in biceps ; in phalanges of thumbs ; in 1. leg near knee ; in anterior lower 1. tibia ; all over.

Dull pain : in frontal region.

Bruised feeling : all over head.

Sore feeling : in throat ; in stomach ; all over.

Broken-up feeling : in morning after fever.

Lightning-like sensation runs through brain and down r. side of neck into arm.

Tortuous pains : run up into head.

Hollow feeling : in chest.

Uncomfortable feeling : in stomach.

Weariness, painful : in shoulder and elbow-joints.

Throbbing : of temporal arteries.

Chilly feeling: with gooseflesh all over body.

Itching : on internal r. malleolus.

Tissues p. 64

Dropsical symptoms, venous hypersemia and cyanosis.

^▌' Touch. Passive Motion. Touch : spine sensitive to.

Rubbing : > aching spots in head.

Pressure of shoe : < aching of corn.

Skin p. 64

Recommended in plague by Lorbacher.

▌ Dry skin. θ Diphtheria.

Gooseflesh over the whole body, particularly lower extremities 2.

▌ Pallor of skin, with rapid exhaustion. θ Scarlatina.

▌ Cold, clammy sweat all over. θ Tuberculosis.

Cold perspiration after attacks. 6'Epilepsy.

▌ Periodical furuncles and abscesses, which relieve the head. θ Hemicrania.

Stages of Life, Constitution p. 64

▌ Lady, set. 58, hydrogenoid constitution; rheumatic headache.

A man; epileptiform spasms of nine years standing, caused by masturbation and use of spirituous drinks.

A young lady of slender build, set. 20 ; diphtheria.

A stout girl, £et. 10 ; diphtheria.

Strong man of sanguine temperament; intermittent hemicrania of three years standing.

Woman, set. 50 ; diarrhoea.

A tuberculous woman, set. 30 ; suffocative attacks.

Albert S., set. 4; had chills for two weeks; intermittent fever.

Relations p. 65

Compare: Apis (diphtheria), Arsen. (neuralgias, diarrhoea, tuberculosis), Cinchon. (diarrhoea, suffocative attacks in tuberculosis).