Gelsemium Sempervirens - General symptoms

GENERAL

General

After breakfast dull aching in the head, becoming more severe as the day advanced, in the occiput.

headache increased till after dinner, when it was much relieved, but about 4 P.M. returned worse than before, and seemed to increase in severity until in the evening it became excruciating, accompanied with slight nausea.

shaking the head seemed to slightly relieve it (sixth day),.

Pain in the head and eyes. Patients described this pain variously. It was generally limited to the forehead, and most marked just over the eyes. Some called it a dull sensation over the eyes.

others a heavy pain. and others a giddy pain.

and one patient experienced pain over the occiput, with a sensation as though the crown of the head were being lifted off in two pieces. This headache was sometimes absent, and sometimes followed instead of preceding the other symptoms. Dull aching pain in the eyeballs, now and then shooting in character, occasionally worse in one ball, sometimes followed and sometimes preceded the headache. The headache and pain in the eyeballs, intensified on moving the eyes, were often severe. When ptosis was well marked, the effort to open the eyes widely caused considerable pain, and the patient seemed to get relief by closing them,.

I found the doctor sitting on the edge of a lounge, being held by two persons, with the head falling forward, the chin resting on the breast.

I at once had his head raised up, but it immediately dropped forward again on letting go of it, showing that the parts were paralyzed.

at breakfast his chin had dropped down, and it was with difficulty he could keep his head from falling on the table.

could not eat, and with difficulty, on account of his head falling forward, walked into the next room,.

When writing, headache in the top of the head.

afterwards in the left occipital region, directly on both sides and in the upper cervical region, and again on the top, and then in the left side, all whilst engaged in writing a few minutes.

afterwards a settled, dull, dragging headache, mainly in the occiput, in the mastoid and upper cervical region, extending to the shoulder, relieved while sitting, by reclining the head and shoulders on a high pillow.

in the afternoon (seventh day),.

(As usual, after exercise without breakfast, headache on the right side, with occasional throbbing from exertion; better after a sleep of a few hours, but renewed by exertion; ceased in the evening when sitting, as at other times (ninth day); the semilateral headache returns (tenth day); continues, doubtless caused by the exciting news of the day (twelfth day)),.

Severe pain in the forehead and vertex, with dimness of vision.

roaring in the ears. a sensation of enlargement of the head, and a "wild feeling," a confusion, almost amounting to delirium.

these pains would in turn leave, and the pain in the head would recur immediately after,.

In every case the sight was affected. At first the sight without being misty, is not as clear as usual.

then slight mist comes before the eyes, one patient comparing it to "a lot of smoke rising before his eyes," and another to a "thick veil." The sight at last becomes so affected that it fails almost completely, failing first with distant objects, then, as the sight becomes more impaired, nearer and nearer objects become hazy,.

The drug seems to produce two kinds of diplopia, one much more persistent than the other.

As to the transient kind, we find it on many occasions a very passing phenomenon, lasting only a few seconds, then disappearing, then, after a few minutes, reappearing.

In this form images in the median vertical line appeared double, distant objects at first undergoing the duplication.

Sometimes the patient was conscious that the diplopia was coming on; thus one woman said "I know that it is now coming on; I feel such a heavy weight under my upper eyelid." The double vision then came on, and, with the heaviness, ceased in a few seconds.

One image was higher than the other; in this respect the images varied much.

The following descriptive notes were taken down rapidly from the patient, the phenomena occurring as fast as they could be written "One gas-jet appears about six inches above the other, and there is six inches above the other, and there is six inches between them horizontally.

the upper one is to the left.

now the right is upper most.

now the left slightly again.

going over to the right now again.

exactly over one another now, and quite close together.

now again separated, left the highest.

now over one another." With other patients the two images seemed on a level.

Sometimes the drug produces only this transient kind of diplopia; at other times both kinds; and sometimes one kind preceded the other, the transient usually preceding the more constant form, and continuing to recur from time, while the constant form lasted.

The phenomena of the constant form of diplopia follow a definite order, and take place in the upper half only the field of vision.

They occurred first with objects held at the extreme right or left of the visual field; and as the patient passed more under the influence of the drug, then with objects held nearer and nearer the middle line, and at last, usually for a short time only, objects in the median vertical plane seemed double.

As the effects of the drug wore off, the double vision disappeared in the inverse order.

The outer lateral image was the higher, and the further the object was carried to the right or left the greater was the horizontal and vertical distance between the images.

When a colored glass was placed before either eye, the outer and higher image was seen by the covered eye.

When the object was carried high above the head, the two images gradually coalesced, and the object looked very much thinner, "like a thread." With well-developed diplopia there is impaired movement of the eyeball, chiefly affecting, as far as we could ascertain, the external and internal rectus, especially the external, for the outward and inward movement of the eyeball was less free than before the action of the medicine.

The ball appeared to be moved by greater effort, so that when carried as far as the weakened muscles are capable, the ball oscillates, as though the patient with great effort moved it as far as he could, and then the tired muscles gave way a little, but being roused to an effort they carried the eye back again.

the frequent repetition of this effort gave rise to an oscillation.

The external rectus is generally first affected, and not unfrequently one rectus sooner and in excess of the other.

Even when the diplopia is strongly marked, the loss of power over the muscles is not very great, and there is no obvious squinting.

Then, as the patient becomes still more affected, ptosis supervenes, and a great part of the whole of the upper half of the field of vision is cut off.

The loss of power in the eye-muscles is then more marked, but without the occurrence of obvious squinting.

At this time the symptoms no longer follow the order previously described, but assume various phases, often changing rapidly.

Thus, whilst on one side the outer image is the higher, if the object is carried to the other side of the field the inner image becomes the higher; or, perhaps, for the first few seconds the outer and then the inner is the higher,.

Confused vision, especially of distant objects (following vertiginous sensations after breakfast), when turning the eyes the sight is tardy in following the movement, things for several seconds seem to be blurred, the eye remains unfixed in its, new direction, yet no sensation of gauze or film, in part, and finally cured by Aconite ^Acon, it is accompanied with a disposition to partially close the eyes, as if to steady the eyeballs by the pressure of the orbicularis palpebrarum muscles.

the visual confusion might be compared to that produced by alcohol, and gradually wore off by night (second day),.

Burning upon the tongue immediately, which after a few minutes went over the whole mouth and throat, feeling hot like an oven, and thence through the oesophagus into the stomach and abdomen, when the same burning pain passed around in all the intestines.

simultaneously with the descent of the burning pain into the oesophagus, burning in the chest came on, following soon by a stitch in the anterior left lower side of the chest, going through the chest into the left shoulder-blade, and accompanied by weakness and a fluttering and beating of the heart, irregular as to quantity and quality.

these symptoms lasted about three hours (first day),.

Gelsemium produces a peculiar and very marked eruption in most of the provers.

it appears most on the face, less frequently and less conspicuously on the back between the shoulders, etc.

it is papulous, very much the color of the eruption of measles, which it considerably resembles, but the papulae are larger, more distant and distinct.

although very conspicuous, they are attended with little or no sensation, the subject being unaware of their existence until he happens to see himself.

persons have frequently been asked what was the matter, if they had the measles, etc., when they were not aware of the eruption.

this generally appears on the second or third day of the proving, and would seem to be more constantly produced by the 2d or 3d dilution than by the tincture.

the eruption continues one or two weeks, or longer,.

A sore pimple on the left side of the neck at 8 A.M.

the pimple is sore, and has an areola embracing the diameter of a pea, quite red and inflamed (such an eruption not experienced at any other time), (sixth day). Two more pimples, on at the right corner of the os hyoides, the other at the left anterior temporal ridge, above the brow (eighth day). Another pimple, sore to touch, on the left side of the larynx.

the first one less sore, like a small cutaneous induration.

these are like minutes furunculi.

thus far no suppuration (ninth day). The first pimple sorest, the other less so (tenth day),.

Burning in the chest, with fulness, sighing, and anxiousness, going into the pit of the stomach, and radiating all over the whole abdomen like a tree the stem of which is in the pit of the stomach, and the branches of which burn asunder towards the abdomen.

this burning is different in kind from the one observed on the first day.

it is to her feel, not in the intestines, but in the parts covering them.

at 12 M. (fifth day),.

Burning under the lower part of the sternum, with heaviness of the chest, drawing towards the place of the stitch in the left lower anterior side of the chest, which also now is repeated, and pain like ulceration, tender to touch.

as soon as the burning went over to the left side, the chest felt easier.

in the afternoon (eighth day),.

On the 12th of November, at 9 P.M., six drops were taken, at 9.30 six drops more, and at 10 o'clock ten drops.

the results, which were as follows, more also indicated on the chart. Not being perfectly well, there existed either a recoil or dicrotic wave in the preliminary tracing, which in thirty minutes seemed rather to become more prominent, and, but for the records that follow, might be at once set down as a true dicrotous wave, as at this time there will also be seen diminution of compressibility, as shown by diminished amplitude under the same pressure.

the prominence of the waves, whatever its explanation, must be ascribed to a morbid condition, viz., that produced by the influence of the poison administered.

the pulse at this interval has reached a minimum as to frequency, and in ten minutes more shows slight impairment of rhythm.

the new dose of ten drops exhibits its first influence in the tracings in thirty minutes, by increased arterial tension and nervous stimulation, followed however in five minutes by diminution of both, and great decrease in frequency.

from this time on to the end of an hour the tension in the arterial system slowly increased, although the frequency remained nearly the same, and after one hour and a half the appearance of some obstruction, as shown in the flattening of the conjoined apices of the first and second events, was manifest, and irregularity of impulse and of rhythm exhibited the effects of the poison upon the heart. The simple deduction from this investigation, apart from what is already known of the remedy, lies in this, that while reducing the frequency of the pulse, it does so with an increase of arterial tension, and after awhile impairment of the heart's action, indicating a toxic influence upon the nervous system,.

Pulse very uniformly depressed, and rendered less frequent by 10 to 20 beats per minutes, within the last five or ten minutes, if the subject remains quiet, but subject to great variations from exercise.

in one case the pulse increased from 60 to 70 in the first five minutes, but in the next trial it was diminished 10 beats in five minutes,.

After experiencing chills, headache, feverish and prolonged sweating seventeen hours after taking the drug, awakened by severe moving pains in the lower abdomen, soon followed by a very large but natural stool, without relief of the pains, and soon after a deeply bilious discharge, with instant relief of the pain.

nine hours afterwards another bilious evacuation without pain (one case),.

Could not get asleep for a long time.

on falling asleep, a sort of nightmare awoke me again, so that no sleep came.

at last it was like falling asleep, when a second time a kind of nightmare came on, never experienced before.

it was as if the whole left side from the neck along the chest, trunk, and thigh, as far as the knee were a kind of soft muscle, spasmodically jerking up and down, somewhat with the elasticity of a mass of jelly.

this motion extended deep into the interior of the chest, and the centre of this motion seemed to be in the region of the heart.

it was, indeed, one great motion which concerned the whole left side as a mass, with the exception of the head and foot.

this whole half of the body seemed to me to be going up and down, while the right side of the back, on which I lay, was quiet.

I wondered in my mind at this turmoil going on in my body, but was unable to stir.

when I wake up from this condition, I was well aware of what had happened, and found myself quietly lying on the same spot where I had fallen asleep, and the pulse, with everything else, was quiet.

I certainly had not moved, and all, then, was my imagination.

I only felt a drawing pain in te lower third of my left thigh, which was repeated the next day,.

At 10 A.M. I went to the Penn Hospital, where I saw a number of severe wounds.

I am not usually affected much by the sight of wounds, but to-day, that or something else caused very unpleasant sensations.

I became very weak, and my friend remarked that I was very pale, accompanied with nausea and trembling of the lower extremities.

these continued some ten minutes, but disappeared in the open air (sixth day),.

In my own provings, I have frequently experienced a succession of acute, sudden, darting pains, evidently running along the single nerve branches in almost every part of the body and limbs, sometimes so sudden and acute as to make me start.

at one time, a quick succession of these acute sudden pains coursed down the outside and front of the tibia for over half an hour, leaving a line of considerable tenderness marking its track,.

In a few minutes she said she could not see.

her head felt strangely. She took an emetic of mustard, which caused vomiting before the writer arrived. Found the patient in the following condition.

Could not see. the blindness was complete. Neither could she talk or swallow.

the glottis was spasmodically closed. She could moan, which she did almost continually.

but the power of articulation was gone. Great trembling, with anxiety.

was afraid she was going to die, and was very anxious to know if anything could be done. Face swollen and of dark color.

eyes distended. pupils dilated.

great prostration. pulse small and rapid.

tongue and throat very dry,.

At 4.30 P.M., having swallowed two ounces of whiskey, with a view to its stimulating action upon my pulse, and having walked rapidly some distance, I had a full, strong pulse of 100 per minute, my normal pulse being 85 per minute. I injected under the skin of my left arm five minims fluid extract. I examined my pulse at 5 o'clock, and it had fallen to 84.

vision a little indistinct.

at 5.30 pulse was down to 80 beats per minute.

vision more disturbed. At 6 o'clock pulse 76, and temperature 98 1/5°.

disturbance of vision very great. It seemed almost impossible for me to fix my gaze upon any object, and when I succeeded in doing so, the object, whatever it happened to be, would fade away at first, and then reappear again. There was a sensation of fulness in my head, and a feeling of great weight and heaviness about the eyelids. When I opened my eyes to their fullest capacity, it seemed as through they were but half open. At 6.15 pulse was 72, no change in the other symptoms. At 6.30 pulse stood 69. At 7 o'clock I partook of a light supper. At 7.45 pulse was 60, and respiration 15.

no change in temperature. The disturbance of vision completely passed off at 8 P.M., after which time no uncomfortable symptoms were experienced. At 8.15 pulse 60, respiration 15, and temperature 97 2/5°. At 8.45 pulse 59, and temperature 97 2/3°. At 9.15 pulse 60. At 9.45 pulse 60, and temperature 97 2/5°. I then arose from the half reclining position which I had occupied during the experiment, and walked across the room rapidly for five minutes. On resuming my former position, my pulse during the first minute indicated 67, but in ten minutes it had fallen again to the old rate of 60 per minute. The temperature was not at all affected by the exercise the thermometer recording 97 2/5° as before. At 10.30 pulse 58, and temperature 97 1/5°.

at this time I passed eight ounces of rather high-colored urine. I now ascended two flights of stairs and returned, but there was no increase in the pulse or temperature produced by the exercise. At 11 P.M., pulse 63, and temperature 97 1/5°.

the former very soft and compressible. At 11.30, pulse 60, and of the same character.

temperature 96 3/5°. Retired at 12.30, and slept soundly for five hours. Awaking at 7.30 A.M., I about several times, after which my pulse was 61, irregular and compressible.

temperature 97.4°. During the forenoon I passed an unusually large quantity of urine, and my pulse did not regain its normal force and frequency until 10 o'clock in the morning,.

Centers its action upon the nervous system, causing various degree of Motor paralysis. General prostration. Dizziness, drowsiness, dullness, and trembling. Slow pulse, tired feeling, mental apathy. Paralysis of various groups of muscles about the eyes, throat, chest, larynx, sphincter, extremities, etc. Post-diphtheritic paralysis. Muscular weakness. Complete relaxation and prostration. Lack of muscular coordination. General depression from heat of sun. Sensitive to a falling barometer; cold and dampness brings on many complaints. Children fear falling, grab nurse or crib. Sluggish circulation. Nervous affections of cigar makers. Influenza. Measles. Pellagra.

ACHING, TIRED, HEAVY, WEAK AND SORE; worse limbs

Grippe

Overpowering aching Heavy single parts, heart, liver, etc

Lies quietly, half reclining

Nerve exhaustion

Dull, drowsy and dizzy TREMOR; or twitches of single muscles, face, chin, tongue, etc

; wants to be held Chorea, of pregnancy

Paretic effects; eyes, throat, anus, bladder, etc

Inco-ordination

Fulness Passive congestion Symptoms accompanied by vertigo, eye or visual effects, drowsiness or polyuria

CONFUSED, dazed, apathetic, torpid, dull, drowsy and dizzy, or indifferent; answers slowly

VERTIGO; drunken; in occiput

Apoplexy

Suffused, sore, aching eyes HEAVY, DROOPING EYELIDS

VISION; double; swimming; blind spells; affected, then migraine

Face full, dusky-red; heavy, expressionless; besotted Ciliary neuralgia; pains into ears on swallowing

Pains to occiput Nose stuffed

Sneezing; thin, acrid coryza Sensation as of hot water flowing from the nostrils

Heavy tongue; thick speech THIRSTLESS Griping in gall-bladder

Copious, yellow stools

Painless, nervous diarrhoea

Rectal pains after labor

Clear, watery urine, better headache

Alternate pelvic and head symptoms

Atonic seminal losses

Heavy, sore uterus; it feels grasped

Dysmenorrhoea

Labor pains go up, backward or down thighs

Rigid os

Deep yellow leucorrhoea

Hoarse, during menses

Tiresome breathing

Chest; as of a lump behind sternum; congestion

Heart sore; threatens to stop, must move

Spine, dull pains up and down, better walking; with occipital pain

Pains under scapulae Hard ache in r

humerus

Wants hands in cool water

Heavy lower limbs

Weak knees, worse descending

Tottering gait; can't direct his legs

Moist, yellow skin DROWSINESS; starts on dropping to sleep

Heavy, stupid sleep

Full, round, soft pulse Blood rushes from occiput to forehead

Visual disturbances, then chill

Chilly and achy; with languor (Silicea ^Sil---- ); mingled or alternating with heat; up and down back Cold hands and feet

Heat with sopor ABSENCE OF THIRST, or trembling

Cold sweat on genitals

Fevers; bilious-remittent; malarial; cerebro-spinal

Measles Ebullitions and heats

Sluggish fever

Shuddering chill

Gelsemium sempervirens. G. Lucidum. G. Nitidum. Bignonia sempervirens. Yellow jessamine. N. O. Loganiaceae. Tincture of the bark of the root.

suppressed. Metrorrhagia. Myalgia. Neuralgia. Nystagmus. Oesophagus, stricture of. Paralysis. Paralysis agitans. Paraplegia. Pregnancy, albuminuria of. Ptosis. Puerperal convulsions. Remittent fever. Retina, detachment of. Rheumatism. Sexual excess, effects of. Sleep, disordered. Spasms. Sun-headache. Sunstroke. Teething. Tic-douloureux. Tabacum ^Tobacco, effects of. Tongue, affections of. Toothache. Tremors. Uterus, affections of. Vertigo. Voice, loss of. Writer's cramp.

Gelsemium, which belongs to the same order of plants as Nux Vomica ^{Nux vomica} and Curare ^Curare, is not only one of the most important additions to the materia medica for whose introduction we are mainly indebted to Hale, but it is also in the first rank of importance among the vegetable polychrests. A drug is of importance in homoeopathy not so much by reason of the great number of the symptoms it causes, as by possessing a number of well-marked and clearly characterised symptoms which correspond to symptoms constantly met with in every-day practice. It was this which at once gave Gelsem. a place among the polychrests of homoeopathy. Like its botanical relatives, Gelsem. is a great paralyser. It produces a general state of paresis, mental and bodily. The mind is sluggish.

the whole muscular system is relaxed.

the lassitude is expressed by the patient.

with Muriaticum Acidum ^{Mur. ac}. there is the lassitude, but the patient does not express it. The same paretic condition is shown in the eyelids, causing ptosis.

in the eye muscles, causing diplopia.

in the oesophagus, causing loss of swallowing power.

in the anus, which remains open.

in diarrhoea from depressing emotions or bad news.

in relaxation of the genital organs. Functional paralyses of all descriptions. This is shown again in some features of the headaches. They are accompanied by blurring of the sight, and relieved by a copious discharge of watery urine from a paretic condition of the kidneys. Conversely there may be a desire to urinate during the night, and if the call is not immediately responded to a violent headache supervenes. Post-diphtheritic paralysis.

debility after pollutions.

in three minutes the convulsions were at an end. White had to ride twelve miles over mountains to reach the patient after receiving the summons, so the convulsions must have lasted a considerable time. Tremor is a keynote of the remedy. Gels. is adapted to children and young people.

to persons of a nervous, hysterical temperament.

to irritable, sensitive, excitable people. The following provings related by Dr. George Logan, of Ottawa (Med. Adv., xxiii. 125) show the power Gels. has over the mental sphere. The subject of the first was Mrs. Logan, who describes her experience thus- "A few moments after taking the medicine there is an extreme feeling of restlessness.

not able to be still for a second, keep turning and twisting all the time. This is succeeded by intense pain over the right eye, always the right.

it seems as if my forehead would come right over my eyes and close them.

my eyes feel as if they were turning into my head, roll up all the time. Then a strong inclination to commit suicide. Want to throw myself from a height.

invariably think of going to the window and dashing myself down.

feel as if it would be a relief. This is succeeded by an inclination to weep, and I generally have a good cry, but before I cry and while the feeling lasts of wishing to throw myself from a height, I clench my hands, and nervous rigors or sensations run all over my body down to my fingers and toes.

it seems as if I would lose my senses. Then a great dread of being alone seizes me, and I am afraid of what may happen.

think I may lose all self-control. The pain still continues over the right eye, and often the back part of my head seems to have a spot about four inches square that is turning to ice. These feelings are followed by a strong inclination to talk or write, very great exhilaration, and a better opinion of my mental capacity.

indeed it seems as if my memory was better, that I can recall almost anything I ever read.

nearly always repeat long passages of something to myself that I have read years before. It appears to me that I can remember almost anything I love to recall. Now this is my invariable experience whenever I take Gelsemium─no matter whether in the 3rd or 1,000th potency.

have a perfect horror of being alone. I find Cinchona an antidote for most of the symptoms, but it leaves me much exhausted, thoroughly tired, and with a wish to be quiet." Dr. Logan adds that he first gave the patient Gels. 2 for insomnia and headache. It produced the symptom "wishing to throw herself from a height" so markedly that he was alarmed lest she should carry it out. A year or two after, wishing to give the remedy again, he gave two pellets of the 30th

" I gave Mr. Dorion, since Dr. Dorion, of St. Paul, five or six, drops of Gelsemium 1st for some ailment the nature of which I fail now to remember. Within a few hours after taking the Gelsemium I was sent for to see Mr. Dorion, who, I was told, was 'insane.' He was brandishing a sword in a threatening manner, and frightening all the occupants of the house. On my arrival at his room I found him in the position of 'shouldering arms' with his sword. I playfully admired his military appearance, and thus secured the dangerous weapon, very much to the relief of his fellow-boarders. It then occurred to me that the symptoms were produced by Gelsemium, and placing him in charge of one of the boarders, I returned to my office in order to procure the antidote, of which I was unaware at the time. I gave Cinchona 30 each half-hour, which, in the course of two or three hours brought him all right again." J. H. Nankivell drank two ounces of tincture of Gelsem. instead of a glass of sherry. He walked a few feet with assistance and in another minute his legs were paralysed. He dragged himself to the bedside with his arms, but they were unable to help him to bed, into which he had to be lifted. As long as he lay quiet there was no trouble, but on the least exertion there were excessive tremors. Vomiting occurred during the next twenty-four hours. Temperature rose to 101.5° F. Heart's action very violent and intermittent (possibly an aggravation of existing disease). All the muscles of the eyes were affected, but of voluntary muscles those of the right side suffered most. Prolonged conversation involved paralysis of upper lip. There was somnolence.

absence of mental excitement.

and good appetite. The effects passed away in the order of occurrence, from below upwards.

but after the arms had recovered, vision was not perfect for twenty-four hours. A patient of mine once took a drachm of the tincture for a headache. On going out he could not tell which side of the street he was on. He was near St. Paul's Cathedral and saw two cathedrals instead of one. The following case of poisoning was recorded by Dr. Edward Jepson (Brit. Med. Jour., Sept. 19, 1891, p. 644). Although Gels. was given with other drugs, and on the last occasion with one of its antidotes (quinine), which probably saved the patient's life, the symptoms are unmistakably those of Gels.- "About two months ago Miss W., aged about forty, an inmate of my house, was seized with very severe neuralgia about both temples. I gave her tincture of Gelsemium 10 minims, with a bismuth mixture to be taken every two or three hours. After taking this for about a day and obtaining no relief.

I gave her the full dose of the tincture of Gelsemium, according to Squire's Companion of the Pharmacopoeia, 1882, and Whitla's Materia Medica, third edition, namely, 20 minims in a quinine mixture.

Gelsemium Sempervirens was taken every three hours, but with only moderate relief, three or four doses having been taken during the night.

At about eight o'clock the following morning Miss W. was able to speak pretty well, and said she thought she was better.

At about nine o'clock she was speechless and in the greatest distress of mind and body; there was total loss of power in the tongue; it could not be protruded, she could not articulate, and with very great difficulty could she swallow the brandy and water we forced upon her.

There was alteration in vision; she could not distinguish us clearly, and the pupils were widely dilated.

She had uncertain power over the muscles of the hand and arm, so that she could not write her name.

All this time she was perfectly conscious, and nodded her head in answer to questions.

She was greatly alarmed as to herself, and, as she informed us afterwards, she thought she was about to have a fit.

Not knowing of any special antidote for Gelsemium, and seeing that there was no time to lose if we wanted to avert any increase of the paralysis, it fortunately came into my mind to give her a subcutaneous injection of Strychnine, using 1 minim of the liquor Strychninae, or 1-120th part of a grain.

Ten minutes after this the change for the better was most marked; there was return of power in the tongue and in the hands, and an improvement in the vision.

. I again injected a minim of the Strychnine, and with further improvement in the condition of the patient.

After this she took food and stimulants, and all paralysis disappeared.

The vision was not perfectly restored for some hours, the pupils being less dilated.

She had some return of the neuralgia, and was very weak for a few days, but eventually she quite recovered, and has had altogether better health since this event than she had prior to it." Gelsem. in the attenuations is a great neuralgic remedy.

I have cured among other cases one of neuralgia of the anterior crural nerve.

The tongue is only thinly coated, and has not the dark streak of the Baptisia Tinctoria ^Bapt. tongue.

The Gels. face is flushed crimson, but not quite as besotted as that of Baptisia Tinctoria ^Bapt.

There is excessive weakness and trembling, but the consciousness is not so clouded.

In coryza and hay fever Gels. has an important place.

Early morning sneezing and streaming colds are a strong indication.

The characteristic headache of Gels. begins in the occiput and spreads over the whole head, settling down over eyes.

Dizziness and dim vision, and dizziness rising up from occiput and spreading over whole head, with depression, from heat of summer.

Headache with stiff neck, agg. in morning; amel. urinating; preceded by blur before eyes, drowsiness with headache, difficulty in keeping eyes open, dull headache over eyes to vertex and occiput, with irregular action of eye-muscles.

Neurotic symptoms in cigar-makers, impotence, palpitation.

Many symptoms occur in connection with the sexual organs, male and female.

Dysmenia; epileptiform convulsions at menstrual period; rigid os in labour; chill, beginning in hands; or feet; and running up back.

There is agg. both before, during, and after menses.

Itching of skin; eruption like measles.

Sensations of lightness of head, of body.

Sensation as if the head were enlarged.

as if there were a tape round the head.

as if the skin were contracted in the middle of the forehead.

sensation from throat up into left nostril like a stream of scalding water.

sensation as if a lump were in oesophagus.

load in stomach as if stomach were quite gone.

as if the uterus were squeezed by a hand.

as if he would die. as if the blood ceased to circulate as if the heart would stop unless he kept moving.

as if a knife were thrust through from occiput to forehead.

as if eyes were jumping out of head.

as if a lump were in throat which could not be swallowed.

The stools of Gelsem., whether loose or constipated, are mostly yellow, like the flower.

The colour comes out also in the colour of the tongue, and bilious symptoms generally.

Wants to lie down and rest.

Wants to be held, that he may not shake.

Motion agg. most symptoms; amel. muscular pains; amel. heart.

Rising from seat = pain in heart.

Shaking head amel. heaviness of head.

Lifting arms = trembling of hands.

Playing piano = tired sensation in arms. (J. G. Blackley pointed out the suitability of Gels. to writer's cramp and professional paralyses. I have relieved with it cases of Dupuytren's contraction.) Great distress and apprehensive feeling at approach of a thunderstorm.

Heat of sun or summer agg.

Hot applications amel. pain back of head.

Must be covered in all stages of the paroxysm.

Complaints from sudden change from hot or dry to damp air.

Catarrh occurring in warm, moist, relaxing weather. agg.

Damp weather; cold, damp atmosphere; amel. cold, open air; agg. from fog.

Cold drinks are vomited immediately; warm or spirituous drinks can partially be swallowed. "amel.

From stimulants" is a very general characteristic.

Yellow Jessamine. Wm. E. Payne. Loganiaceae.

* * *

Weather If you will observe the weather conditions in sharp climates, such as Minnesota, Massachusetts and Canada, you willfind that the cold spells are very intense and that people when exposed, come down with complaints very rapidly and violently.

That is the way the Belladonna ^Bell and Aconite ^Acon cases come on, but Gelsemium complaints do not come from, such causes nor appear that way. Gelsemium Sempervirens's complaints are more insidious and come on with a degree of slowness.

A Gels cold develops as symptoms several days after the exposure, while the Aconite ^Acon cold comes on a few hours after exposure. The Aconite ^Aconite child exposed during the day in dry, cold weather will have croup before midnight. But in the South diseases are very slow. Like the people themselves, their organs are very slow, and their reaction is slow.

Their colds are not taken from the violent cold, but from getting overheated. Hence, they take colds and fevers of a low malarial type.

they have congestive headaches and congestive complaints that do not come on suddenly. When we think of the climate, and consider the people, and the pace of remedies, we see that Gels is a remedy for warm climates, while Aconite ^Acon isa remedy for colder climates.

Certain acute complaints in the North will be like Aconite ^Aconite, while similar complaints will have symptoms in the warmer climate like Gels. The colds and fevers of the mild winters will be more likely to run to this medicine, whereas the colds and fevers of a violent winter will be more likely to run to Belladonna ^Bell and Aconite ^Acon

It istrue that Aconite ^Acon has complaints in hot weather, fevers and dysentery of hot weather, but they are different from the complaints of winter.

Gels has been used mostly in acute troubles. In lingering acute troubles and in those resembling the chronic it is very useful, but in chronic miasms it is not the remedy. It is only a short-acting remedy, though slow in its beginning. In this it is like Bryonia ^Bryonia Bryonia ^Bry complaints come on slowly, and hence it is suitable for fevers coming on in the southern climate, but it also has sudden violent complaints, though not to the extent we find in Belladonna ^Bell

Complaints The complaints of Gels are largely congestive. Cerebral hyperemia, determination of blood to the brain and to the spinal cord. The extremities become cold and the head and back become hot. The symptoms are manifested largely through the brain and spinal cord. In connection with brain affections there are convulsions of the extremities, crampings of the fingers and toes and of the muscles of the back.

Coldness of the fingers and toes; sometimes the extremities are icy cold to the knees, while the head is hot and the face purple. During the congestion the face is purple and mottled. The eyes are engorged, the pupils dilated (sometimes contracted), the eyes are in a state of marked congestion with lachrymation and twitching.

The patient feels dazed and talks as if he were delirious; incoherent, stupid, forgetful. It is like this in intermittent fever that gradually develops towards a congestive chill. Great coldness running up the back from the lower part of the spine to the back of the head. Shuddering, as if ice were rubbed up the back.

The pains also extend up the back. With the coldness of the extremities, the very dark red countenance, the dazed condition of the mind, the glassy eyes and dilated pupils, we have the neck drawn back and rigidity of the muscles of the back of the neck, so that the neck cannot be straightened, and there are violent pains up the back and coldness in the spine.

Gelsemium Sempervirens is a very important remedy to study when such symptoms are present in intermittents and in a few days the tongue begins to coat, nausea comes on, ending in vomiting of bile, and instead of there being an intermission a continued fever extends from one paroxysm into another, with a higher temperature in the afternoon.

In congestive chill with high temperature occurring in the afternoon, the chill part of it subsiding and the fever becoming continued, Gels is a useful remedy. It is also a very important remedy in afternoon fevers without chill in infants and in children. You will find in malarial districts that it is a common thing for the infants to have remittent attacks, while the adults are having intermittents. it is only occasionally that you will see a child or infant shake with a distinct chill, but they often go into a remittent fever, an afternoon fever which will subside along towards morning, to be followed the next afternoon by fever. With Gels the child will lie as still as in Bryonia ^Bry but there is more congestion to the head there is the dark red face and duskiness like Bryonia ^Bry

The head cannot be lifted from the pillow, so tired and so heavy is it, and there is such a great weight in the limbs. The Bryonia ^Bry patient lies quietly because if lie moves the pains are worse. He has an aversion to motion, because he is conscious that it would cause an increase of suffering.

The heart is feeble and the pulse is feeble, soft and irregular. There is palpitation during the febrile state. Palpitation, with weakness and irregularity of the pulse. There is a sense of weakness and goneness in the region of the heart, and this weakness and goneness often extend into the stomach, involving the whole lower part of the left side of the chest and across the stomach, creating a sensation of hunger, like Ignatia ^Ignatia and Sepia ^Sepia There is a hysterical element running through Gels and it has the nervous hunger, or gnawing.

There are cardiac nervous affections like Digitalis Purpurea ^Digitalis, Cactus Grandiflorus ^Cactus and Sepia ^Sepia. Sepia ^Sepia is not known to be as great a heart remedy as Cactus Grandiflorus ^Cactus, but it has cured many cases of heart troubles. Sepia ^Sepia has cured endocarditis, and a remedy that will take hold in endocarditis and root it out must be a deep acting remedy. He feels that if he ceases to move the heart will cease to beat.

The headaches are of the congestive type. The most violent pain is in the occiput, and it is felt sometimes as a hammering. Every pulsation is felt like the blow of a hammer in the base of the skull. These headaches are so violent that the patient can not stand up, but will lie perfectly exhausted, as if paralyzed from the pain. There is an occipital headache that compels walking or rolling the head.

There is commonly relief from lying in bed, bolstered up by pillows, with the head perfectly quiet The face is flushed and dusky and the patient is dazed. After the headache progresses a while, the whole head seems to enter into a state of congestion, there is one great pain, too dreadful to describe, and the patient loses his ability to tell symptoms and appears dazed.

lies bolstered up in bed, eyes glassy, pupils dilated, face mottled, and extremities cold.

Gels has also headaches of a neuralgic character in the temples and over the eyes, with nausea and aggravation from vomiting. The headache is relieved by passing a copious quantity of urine; that is, the urine which has probably been scanty becomes free and then the headache subsides.

There is much nervous excitement. Complaints from fear, from embarrassment, from shock that is attended with fear, from sudden surprises that are attended with fright. A soldier going into battle has an involuntary stool.

involuntary discharges from fright and surprises accompanying fright. On becoming suddenly overwhelmed by some surprise he becomes faint, weak and exhausted, he becomes tired in all the limbs and unable to resist opposing circumstances. His heart palpitates. This is similar to Argentum Nitricum ^{Arg. nit}. Argentum Nitricum ^{Arg. nit} has the peculiar condition that when dressing for an opera a sudden attack of diarrhea comes on, causing more or less sudden exhaustion, and she must go several times before she can finish dressing.

They who are to appear before an audience are detained because of a sudden attack of diarrhoea. A lady has an attack of diarrhoea when about to meet friends over whom she expects to become excited at the meeting. The anticipation brings on the diarrhoea. Such a state is Argentum Nitricum ^{Arg. nit} These medicines are so closely related to each other that there are times when they will appear to do the work of each other.

Then we have paralytic affections of the sphincters, and so with the febrile conditions there is involuntary loss of stool and urine. There is also paralytic weakness of the extremities and of the hands. With paralytic states there is aching along the spine and in the muscles of the back.

drawing, cramping in the muscles of the back and aching under the left shoulder blade.

There are many disturbances of vision.

double vision, dimness of vision, appearance of a gauze before the eyes.

confusion of vision and blindness. These symptoms come on before going into attacks, in connection with chill, at the coming on of sick headaches and congestive headaches. All sorts of objects are seen.

the field of vision appears full of black spots, or full of smoke or little waves of various colors. It is useful in inflammation of all the tissues of the eye and of the eyelids. The eyeballs oscillate laterally when using them.

Drooping of the eyelids or ptosis is a marked feature and is in its paralytic nature.

The muscles are relaxed, they do not hold the lids tip. The lids close when he is looking steadily; they simply fall down over the eyes.

The patient in general is thirstless, and it is the exception that there is much thirst. It has a profuse, exhaustive sweat and is aggravated from motion, or rather motion seems to be impossible. It seems that he is unable to move, that be is too weak to move, and this runs through all complaints. At times it is a remedy for coryza, with sneezing and running of water from the nose, with coldness in the extremities, and the trouble will go down into the throat and produce sore throat, with redness, tumefaction, enlargement of the tonsils, hot head and congested face.

With this, as with the other febrile conditions, there is heaviness of the extremities. The red face, the heaviness of the extremities and sore throat that has come on gradually, a little worse from day to day, until it has become a severe throat, will lead you to Gels, especially if there is paralytic weakness all over, and as the throat trouble progresses the food and drink come back through the nose.

Gelsemium Sempervirens is due to a paralysis of the muscles of deglutition. The tongue also becomes paralyzed and don not perform its work in an orderly way. There are times when the paralytic weakness is not sufficiently marked to account for things seen, but there is an incoordination of muscles and he is awkward. He undertakes to, take hold of an article and takes hold of something else. When he does grasp his hands feel weak. He is awkward and clumsy and the muscles do this and that and something not ordered to do.

The trembling incoordination and paresis are especially noticed during high excitement and afterwards, and these states occur with the febrile condition and remain sometimes after. Useful in paralytic cases that begin with fevers. Tearing is felt in the nerves all over the body and seems to be due to an inflammatory condition. It has cured sciatica, with tearing pains, associated with great weakness of the limbs.

Loss of sensation is sometimes found; numbness of the end of the nose, of the ears, of the tongue, of the fingers, of the hands and feet, numbness, here and there, of the skin.

In the male, the sexual organs arc in the same condition as the patient in general. The semen dribbles away; there is impotency, no ability to perform the sexual act; the sexual organs are relaxed.

The sleep is greatly disturbed. He cannot go to sleep.

every excitement keeps him awake. During marked febrile conditions he has a profound sleep or coma. When he is not in this comatose sleep during congestion he is in a state of nervous excitement in which he lies awake thinking, and yet thinks of nothing in particular, because his!mind will not work in an orderly way.

The symptoms of Gels may be present in inflammation of any organ, uterus or ovaries, stomach, the lungs and of the rectum. It has congestion of organs, but it has also high grade inflammation. There is nothing peculiar in the inflammation itself that would indicate Gels, neither should Gels ever be given because there is inflammation, but when the mental symptoms are present, the delirium, the flushed face, the determination of blood to the head with the cold extremities, the great heaviness of the limbs, the disturbance of sensation, the paralysis of sphincters, then Gels would be good for inflammation of any organ of the body.

Many times when erysipelas has spread over the face and scalp and in the most dangerous manner with the dusky red color that belongs to Gels, and other symptoms such as I have described in a general way, Gels has taken bold of the erysipelas and cured. If we master thoroughly the Materia Medica we do not stop to see if a remedy produces certain kinds of inflammation, etc., but we consider the state of the patient.

Complete relaxation and prostration of the whole muscular system, with almost or entire motor paralysis. Eyelids droop; muscles refuse to obey the will

Trembling of hands or lower extremities if he attempts to move; must lie still

Mental faculties dull, cannot think; drowsy, with dull red face

Susceptibility to mental disturbance, excitement or emotion; causes diarrhoea

Dull, tired, prostrating headache at base of brain; wants head high, sometimes better by profuse urination

Vertigo with blurred vision; dilated pupils; double sight; sense of intoxication

Nervous chill, violent shaking with no sense of coldness

Desire to be quiet; feels too weak to move

Children fear of falling, seize the nurse, grasp the crib, especially in intermittents

Slow, weak pulse of old age

Great heaviness of the eyelids; cannot keep them open

Fears that unless constantly on the move, the heart will cease beating

General deep-seated muscular pain with prostration (la grippe)

Gelsemium Sempervirens affects, primarily, the whole nervous system. the most prominent symptom, as we are in the habit of recording the effects of remedies, is "complete relaxation and prostration of the whole muscular system, with almost or quite entire motor paralysis." This muscular prostration seems to come through inability of the nerves to convey impressions; thus we have the symptom "muscles will not obey the will." This condition comes on gradually, the first symptom being a feeling of lassitude or general fatigue. He wants to lie down he feels so weak (Picricum Acidum ^{Picric acid}), and is inclined to drowsiness.

Then again, there may be neuralgia in various parts, and the pains may be a dull aching all over (myalgia), or they may be sudden and darting, so acute as to cause sudden starting. Or, again, it may cause spasms or convulsions; but with all these there is the characteristic prostration, for instance, in prosopalgia the eyelids droop from weakness. So we repeat Gelsemium is pre-eminently a nerve remedy.

Having shown the central action of this great remedy as it manifests itself upon the nervous system, we will proceed to notice some of its local uses which will always be more or less associated with such action. Upon the mind it shows its depressing power, and is portrayed in such symptoms as these The Gelsemium subject is torpid, sleepy and dreads movement. The mental faculties are dull, cannot think clearly or fix his attention "desires to be quiet; does not wish to speak or have any one near her for company, even if the person be silent." This condition of mind is in perfect accordance with the general nervous prostration already described. This condition of mind sometimes is temporarily suspended to give place to an alternate condition of excitement. But this is not the leading, characteristic, and legitimate effect of the drug, but is only the reaction.

There is an excessively sensitive condition of the nerves that is very peculiar, and that Gelsemium Sempervirens controls markedly, viz., susceptibility to mental disturbance, such as sudden excitement or emotion, bad news or fright, the anticipation of an unusual ordeal. One of the effects following these things is a diarrhoea. Many people are thus affected. Gelsemium not only cures the diarrhoea for the time being, but often cures the whole abnormal condition. I have never known the remedy to do much good in these conditions below the 30th potency, but often in the potencies much above that

As would be naturally supposed from its general action upon the nervous system, Gelsemium Sempervirens exerts a decided influence upon the sensorium and brain. Dizziness, with blurred vision, pupils dilated, double sight and sense of intoxication, show this influence. One very characteristic symptom appears here which is found under only one other remedy with any prominence, viz., "child starts and grasps the nurse and screams, as if afraid of falling." If there is any difference between it and Borax ^Borax, it is that in Borax ^Borax the child manifests this fear only when it is being laid down in the cradle, or from downward motion

The most characteristic headache of Gelsemium is a dull, tired headache at the base of the brain.

The patient wants to lie with head raised upon a high pillow, and lie perfectly still.

It is aggravated by mental labor, smoking tobacco, lying with the head low, and in the heat of the sun. (Glonoin ^Glonoine, Lachesis ^Lachesis, Lyssin (Hydrophobinum) ^Lyssin, Natrum carb.).

It is temporarily ameliorated by pressure and stimulants.

Such headaches often follow a debauch.

Sometimes we have a headache from passive congestion; then the pain begins in the occiput and spreads all over the head.

The aggravations are about the same as in the other variety, or nervous headache.

One notable characteristic is that sometimes the headache is relieved by a profuse flow of urine. (Lac Defloratum ^{Lac defloratum} has a profuse flow of urine during sick headache to which it is adapted, but the pain is not so markedly relieved by the flow). Gelsemium has also a sick headache that is preceded by blindness.

As the head begins to ache the blindness disappears.

The sick headache of Gelsemium Sempervirens is not accompanied with much nausea and vomiting, as is that of Sanguinaria Nitrica ^Sanguinaria, Iris Versicolor ^{Iris versicolor} and Lac Defloratum ^{Lac defloratum}, but is accompanied by the characteristic weakness and trembling belonging to Gelsemium Sempervirens. Gelsemium is one of the so-called fever remedies.

It is useful in the remittent fever of children.

The fever is never of that active or violent form calling for Aconite ^Aconite or Belladonna ^Belladonna, but of a milder form.

The child lies drowsy, does not want to move, or, if it does, cannot move much on account of the weakness.

One author says that Gelsemium stands midway between Aconite ^Aconite and Veratrum Viride ^{Veratrum viride}.

I should rather place it between Baptisia Tinctoria ^Baptisia and Belladonna ^Belladonna.

There may be dark red face with both and a sort of besotted expression; but with Baptisia Tinctoria ^Baptisia the sensorium comes more fully under the influence of the drug, so that the patient will fall asleep even when trying to answer questions.

Then the offensive sweat, stool and urine of Baptisia Tinctoria ^Baptisia are not found under Gelsemium.

Like Belladonna ^Belladonna, there is congestion to the brain and dilated pupils, but it is not so intense, accompanied by active or violent delirium as with Belladonna ^Belladonna.

Gelsemium is not a very great intermittent fever remedy; but is one of the best for nervous chill (Gelsemium chills run up and down the back in wave-like succession from sacrum to occiput; chill begins between scapulae, Capsicum Annuum ^Capsic., Sepia ^Sepia; chill begins in lumbar region, Eupat. purp. and Nat Mur ^{Nat. m}.; chill begins in dorsal region, Eupat. perf., Lachesis ^Lach.).

The pulse of Gelsemium is slow when quiet, but greatly accelerated on motion.

For the weak, slow pulse of old age there is no remedy oftener useful.

Dose

Tincture, to thirtieth attenuation; first to third most often used.

Region

CIRCULATION

BRAIN CORD OCCIPUT

Base

Neck

MOTOR NERVES MUSCLES

Knees

EYES(LIDS)

VISION

MUCOUS MEMBRANES Nose

Gall-ducts

Right side

Characteristics

and I have been in the habit of using it for twenty years. I am writing this under the influence of the drug. I could not give the symptoms so accurately at any other time. As I am getting over the effects of the drug I have to urinate every few minutes. While suffering I like to have people in the room

with the same result. He next prescribed the 1,000th, and the result of that was the proving now related. Here is the second case in Dr. Logan's words

but rather she grew worse, being, as is described, 'nearly mad with pain'