Strychninum - General symptoms - Clarke

GENERAL

General

STRYCHNINUM. Strychnia. Strychnine. An alkaloid obtained from several species of Strychnos. C21H22N2O2. Trituration. Solution. STRYCHNINUM NITRICUM. Nitrate of Strychnine. C21H22N2O2HNO3. Solution. Trituration. STRYCHNINUM PHOSPHORICUM. Acid Phosphate of Strychnine. C21H22N2O2H3PO42H2O. Solution. Trituration. STRYCHNINUM SULPHURICUM. Normal Sulphate of Strychnine. (C21H22N2O2)2H2SO47H2O. Solution. Trituration. STRYCH. VALERIANIC. Valerianate of Strychnine. C21H22N2O2C5H10O2. Solution. Trituration.

Amaurosis. Aorta, pain in. Aphonia. Asthma. Athetosis. Bladder, paralysis of.

pains in. Breasts, pains in. Cough, explosive. Cramps Diaphragm, spasms of. Emphysema. Enuresis. Exophthalmos. Eyes, optic nerve, sclerosis of (n). Headache. Hemiplegia. Influenzinum ^Influenza. Joints, stiffness of. Laryngeal crises of locomotor ataxy. Locomotor ataxy. Malar bones, pains in. Neurasthenia (p). Night-blindness. Paraplegia. Proctalgia. Rheumatism. Scrotum, abscess of. Spinal irritation (p). Tetanus.

Poisonings innumerable with Strychnine are on record, the symptoms being convulsions of a tetanic nature, in the fatal cases ending in asphyxia. The spasms are intermittent, and the least touch or movement is sufficient to induce an attack. Lying on the back is the only tolerable position. Here is a case "Lying on her back, body rigid, jaws set, arms and hands flexed, the thumbs nearly touching across the chest, and the whole muscular system convulsed, with short, jerky spasms, which would continue for about a minute and then remit, the muscles remaining contracted and as hard as wood during the intervals between the paroxysms." The convulsions generally take the form of opisthotonos.

cries, terror, hippocratic countenance, and frothing at the mouth are common occurrences. The Liquor strychniae is responsible for many of the poisonings, the powdered crystals, either pure or mixed in pills or rat-poison, for others. Strychnia itself is very sparingly soluble in cold water (1 in 5760). I have not attempted to distinguish between the different salts of Strychninum ^Strych. An extensive proving of the Liquor Strychninum ^Strych. was made under the supervision of Henry Robinson on two provers, a man and a woman (M. H. R., xii. 252). The man took 900 drops in twenty-three days.

the woman 445 drops in fifty-three days. These have furnished the most distinctive symptoms. Extreme nervous excitability.

visions of an ugly face.

fits of laughing, with light, swimming sensation in the head and giddiness.

involuntary, idiotic-like chuckle.

confusion of ideas, stupor and weariness.

were some of the mental symptoms. The drowsiness was a well-marked feature and characterised some of the headaches. The headaches were frontal largely, or momentary dartings like electric shocks. A lady to whom I gave Strychninum ^Strych. ph. 3x in five-drop doses twenty minutes before meals felt at once constriction of the throat, and after each meal violent headache in forehead over the eyes. The choking sensations were a constant feature in provings and poisonings. A patient now under my care suffering from locomotor ataxy has had among other manifestations alarming laryngeal crises with choking attacks. For these Felix Semon had given him subcutaneous injections of Strychnine, which was exquisitely homoeopathic to the case, and gave marked relief. The direct "tonic" action of Strychninum ^Strych. was shown in one of Robinson's provers, who had "unusually good appetite, she enjoys her food amazingly." Gamper, of St. Petersburg (C. D. P.), experimented with Strychninum ^Strych. Nit. on healthy young hospital assistants and found that it increased the amount of gastric juice secreted, the general acidity, and the quantity of free acid in the secretion. It hastened the absorption from the stomach, and strengthened the mechanical movements. The effects continued some time after the administration was stopped. The action of Strychninum ^Strych. on the rectum and genito-urinary organs was as pronounced as that of Ignatia ^Ign. and Nux Vomica ^Nux.

(and in one case when all other Strychninum ^Strych. preparations had failed, Strychninum ^Strych. val. cured). (4) Spasm of oesophagus in an hysterical woman, Strychninum ^Strych. (5) Brain exhaustion of women in whom high nervous erethism exists. Strychninum ^Strych. val. 2x. (6) Chorea, when the convulsions do not cease during sleep. Strychninum ^Strych. 12, or 30.

A suggestion of Cooper that many cases of persistent cough recurring after Influenzinum ^influenza are met by Strychninum ^Strych. I have found to be correct. The Influenzinum ^influenza cough has in it a strong spasmodic and asthmatic element, whether dry or not, and this seems to give one point of correspondence. C. W. Lawson (quoted H. W., xxxiv. 134) relates the case of a medical man who took continuously for two years Liq. Strychninum ^Strych. Hydrochlor., 5 to 10 minims, thrice daily, with a little Sal volatile. He was at first benefited, but afterwards experienced a desire to take abnormally deep inspirations, "and he felt that to do so would overcome the inhibitory power over the lung, probably the action of the diaphragm." One morning, after a dose of Strychninum ^Strych., he was taking such an inspiration, and from that moment experienced the sensations complained of inability to take a deep breath.

fixation of chest walls compelling him to stoop.

weakness on exertion, great confusion of thought and memory.

occasional clay-coloured faeces, usually greater in amount than ordinary. After six months the apex beat descended to the 6th interspace, and headache and drowsiness became marked. He travelled for six months without benefit. All attempts to act on the heart with drugs increased the headache. Lawson then found the heart dilated, wide subcostal angle, chest emphysematous, moving en masse. After a year of treatment Hyoscyamus Niger ^Hyoscyamus tincture, min. xx. at bedtime, was ordered and proved strikingly beneficial, drowsiness ceased entirely and improvement in all other respects followed.

Peculiar Sensations of Strychninum ^Strych. are Feeling as if head and face were enlarged. As if an iron cap were on head. Paralysed feeling in left half of head and face. Scalp sore, as if hair had been pulled. As if nerves suddenly pulled out of teeth. As of a lump in throat. As if water dripped off right elbow.

at intervals. and off right shoulder. As if chopped in half at waist, at night. The pains and sensations of Strychninum ^Strych. come suddenly and return at intervals. Sudden palpitation. Darting, pinching lancinating, fulgurating, electric pains. "Gurgling noise in rectum with electric darts" is a symptom of one prover. Many pains centre about the lips and eyes. Pains and chills occur in the occiput and nape and run down whole length of spine. There is much itching of the whole body and "violent itching in roof of mouth," which should prove a useful symptom. Jerkings, twitchings, and shocks in all parts run throughout the pathogenesis. The sensitiveness is shown in the increased activity of the spinal senses.

the dread of touch. shrinking from draughts of air.

and in Meyhoffer's prover touch anywhere excited a voluptuous sensation. Stiffness is a leading note of Strychninum ^Strych., and Cooper gives "rheumatism with stiff joints" as an indication. The symptoms are agg. in morning. agg. By touch.

noise. motion. exertion.

walking. agg. After meals. amel. Lying on back.

L. spermatic cord painful, l. testicle swelled, painful only on standing or walking.

hard, swollen, later burning pain on l. side of scrotum where the skin was tense on the testicle, and a large abscess formed in the dartos and cellular tissue.

this was opened by a small incision and yielded a very large quantity of semi-transparent fluid, partly mixed with blood, after the discharge of which the size of the testicle became somewhat less.

there was no connection between the testicle and the abscess.

On washing his hands, half an hour after touching an abrasion on l. thumb with Liquor. Strychninum ^Strych., immediately felt numbness extending from thumb to whole of l. hand and wrist and rapidly to elbow and shoulder.

in two hours joints of all fingers swollen and numbness gone.

later enormous swelling of whole limb.