Digitalis Purpurea - General symptoms - T.F. Allen

GENERAL

General

An active principle (glucoside) of Digitalis purpurea.

, forming most of the soluble part of the commercial Digitaline, a glucoside, C31H53O17 (very closely allied to Saponine C32H54O18), Digitaline, not precipitated by ether from aqueous nor from alcoholic solutions (as is Digitonine), a glucoside, C5H8O2.

Digitaleïne, easily soluble in water (like Digitonine), and also in alcohol (unlike Digitonine), and Digitoxine, the most active principle, the so-called crystallized Digitaline (of Nativelle), insoluble in water, not reducing Cuprum oxide, and therefore not a glucoside, but having the formula C21H82O7, and therefore not an alkaloid.

It is probable that the provings and experiments here recorded are from substances composed of more or less of all of the above active principles, excepting that the Digitaline prepared after Homolle and Quevenne contains little or no Digitoxine. -T. F. A.

Formula, C5H8O2

(Morning), On stooping, immediately after rising, headache.

on waking, headache. on waking, all objects seem covered with snow.

coryza. vomiting.

pain about umbilicus. in bed, pain in abdomen, etc.

in bed, colic. hoarseness.

after rising, dry cough.

on rising from bed, indolence, etc.

on waking, general sweat..

Very violent vertigo, all objects seem to turn horizontally from left to right.

on closing the lids the vertigo was somewhat diminished, but returned on opening them.

I hoped that repeated opening and closing the lids would put an end to this unpleasant sensation, which was accompanied by nausea, but it was not so.

I stood up with some difficulty and dressed myself.

even slight stooping or looking up increased the vertigo and also the nausea, together with coldness of the back, quite cold hands, yawning, and at intervals short dry cough, on waking at 7 A.M. (second morning),.

Slight confusion of the head, which after an hour changed into a pressure in the occipital region.

this continued with intermissions till towards noon.

while the brain was affected in this way I noticed that external objects frequently presented themselves in a false light.

I did not actually see double, but not in a right light (first day),.

Catarrhal affection of both eyes, with soreness of both external canthi with slight secretion.

the eyes pain on sewing or reading.

slight redness (such an attack had been experienced eight weeks previously, and there was doubt whether this was the result of Digitalinum; the trouble was rather obstinate but did not last as long as the former attack),.

Derangement of sight was of two kinds First, a general mistiness of objects, such as is seen before fainting.

and secondly, a large bright spot advancing before him, which sometimes resembled a ring showing prismatic colors faintly, and similar in character to, though less distinct than, that seen round a light when Digitaline has been introduced into the eye,.

When Digitaline is introduced into the eye, it causes smarting and profuse lachrymation, which passes off in a short time and nothing more is felt, except perhaps an occasional rough feeling of the conjunctiva, till four or five hours after, when, on looking at a light, you see it surrounded by a halo, presenting the prismatic colors, and not quite close round the light, but with a dark space between. This halo increases in diameter the farther you move from the light, and becomes smaller and narrower as you approach.

exactly like the appearance when light cirrhi are crossing the moon,.

Flickering before the left eye first appeared (second morning).

towards noon affected also the right, so that he was enabled to distinguish three varieties of figures in the field of vision.

closing the eye and rubbing it slowly caused clouds of phosphorescence.

the eye was very sensitive to light, pupils however not dilated (second day). The figures which the flickering formed in these experiments were called flickering roses, because the form of the rose was the type.

in the first experiment there were round spots in the field of vision, the space circumscribed by four deep oval lines forming four large convex indentations, and the waves of light and shade surrounding this exhibited the same from only less indented.

the flickering figures which appeared on the second day, and which reached their highest point on the third day, were surrounded by curved lines with five indentations, but more superficial, which were again surrounded by enlarging waves of light and shade with superficial indentations.

during the latter days when the flickering decreased, there were noticed only fragments with the rose formation on the side, like the small segment of the larger and more superficially indentated circle,.

Flickering before the left eye, very slight, but therewith he was unable to recognize a distinct conformation in the division between light and shade.

it seemed as though with every wink of the eye the crystalline lens trembled and thereby altered refraction, producing rapid commingling of the lights and shadows of objects (second day).

on the next day the flickering was more noticeable, and not only on winking, but as often as he looked from the light portion of the field of vision (as for example the fireplace) to a dark portion.

this caused the supposition that it was not a mechanical effect, as he was at first inclined to think, but was due to a sudden change from light to shade.

he now directed the eye to the bright sky, and suddenly covered the head without closing the eye or moving it in the slightest, when the flickering was noticed quite as distinctly as before.

on the succeeding day this was more noticed in the right eye.

repeated observations sharpened the vision, and he was able to distinguish a definite conformation.

there seemed to be in the middle of the visual field an alternately disappearing and reappearing roundish spot of a mild light, and about this several concentric waves of light and shade in similar motion.

this flickering continued during the use of Digitalis, for some days (7).

at last it intermitted and appeared for only a short time on going into a room from the open air, after moderate exercise, also on walking or going up stairs,.

Violent coryza occurred without known cause, with pressive-throbbing pains in the arms, and violent headache (this coryza has quite different symptoms from the attacks that I usually experienced, and is remarkably similar to the attack which I had in the beginning of the proving; if this has not been caused by Digitaline, still its course seems to have been modified by it), (thirty-sixth day),.

The pains in the chest were worse in the middle of the day, and were associated with a pressive pain in the right side, which had hitherto been exempt.

these pains occurred in paroxysms and independently of them, and even not aggravated by them, occurred a desire to breathe, that is, a need to breathe very often and as deeply as possible (sixth day),.

Pulse 90, strong and full (after 120 drops).

100, strong and full (after 180 drops), (first day). 120 strong and full (after 240 drops).

125, strong and wiry (after 300 drops), (second day). 150, strong, hard and wiry (after 420 drops), (third day). Pulse never less frequent than in the natural state. 60, small and feeble, but regular (fifth day),.

Pulse 68 before taking.

68 (after five minutes).

72 (after ten minutes).

74 (after fifteen and twenty minutes).

70 (after twenty-five minutes).

68 (after thirty minutes).

after which no farther change was observed, although attention was paid to it for some time longer. It was not only excited in frequency by the simulating power of the pill, but also considerably in force,.

Pulse 80 after gentle exercise (fifth day).

80 when at rest, but rose to 85 or 90 when I had walked for a few minutes (eighth day).

85 whether lying or sitting, 90 to 95 when I had walked a little (thirteenth day).

100 full and strong (fourteenth day).

85 while I remained quiet, although it rose to 100 after gentle exercise (sixteenth day).

80 (seventeenth day). 80 full and strong (eighteenth day).

85, rather weak and irregular, especially after having taken exercise (nineteenth day).

70, softer and fuller (twenty-first day).

softer and fuller, 60 but rose to 75 upon slight exercise (twenty-second day).

50 to 65, when I remained quiet, but rose to nearly its natural number when I used much exertion.

still it was full, although soft and easily depressed (twenty-third day).

it never fell below the degree just indicated, and nearly a week after it had resumed its natural rhythm,.

Pulse before taking, 56 while sitting, at 10 A.M., ten minutes after dose no change.

after twenty-eight minutes, 55 or 56.

but on standing, it immediately rose to 72.

at 6 P.M. 54 to 56 sitting, 68 standing.

at 11 P.M. 69 sitting, 88 standing (first day).

at 10 A.M. 61 sitting, 69 standing (second day).

at 11 P.M. 82 sitting, 90 standing, small, weak, and somewhat irregular, the beat of the heart is stronger and more distinctly felt than usual (fourth day). In the morning, 57 sitting.

at 7 P.M. 74 sitting, 86 the first minute, 94 the second, on standing, without perceptible irregularity it remains for a few minutes at this rate and then becomes slower (fifth day).

at 9 A.M. 52 sitting, 60 standing.

at 11 A.M. 50 sitting, very full, strong, and regular (sixth day).

at 9 A.M. 59 sitting, 72 standing (seventh day),.

Pulse in the morning before exercise was uniformly 60, feeble.

at night after sitting for about two hours 56, feeble, before taking. 70 in the morning.

66 in the evening (first three days). Pulse before breakfast 76, strong.

in the evening 70 (fifth and sixth days). 80 in the morning, 90 in the evening (seventh and eight days), continuing nearly 70 the same for three days, 78, pretty full (tenth day). returned to its natural standard (seventeenth day),.

Pulse averaged in the forenoon 68, abound in the evening 75, before taking.

68 after sitting quietly for an hour.

68 sitting quietly (after half an hour), (first day).

66 (twenty minutes after first dose).

76, of natural strength, after walking four or five times up and down the room.

83 (two hours and a half after first dose), 75 (five hours and a half after first dose), 80 (half an hour after second dose), 76, counted several times in gave the first half minutes 36, the second 40, and 3 beats failed to be felt (one hour after second dose), 80 (nine hours after second dose), 78, weak, beating strong from twelve to twenty times, and then very weak of four or five times (ten hours after second dose), (second day).

62, small and weak in the morning, 72 in the evening (third day).

80, full and regular before taking.

90, weak, three or four pulsations in a minute hardly felt (after three-quarters of an hour).

82, nearly natural in strength, not steadily so (after twelve hours), (fourth day).

76 before taking, 84 (after half an hour).

76, rather weak in the evening (fifth day).

72 before taking, 88 irregular (after one hour), 84 less irregular (after two hours), 72 regular (after four and a half), (seventh day).

72 regular (eight day).

73 in the morning (ninth day).

78 at 6.30 P.M. (tenth day).

73, natural, before taking, 80 (one hour and a half after first dose), 76 (three hours after first dose), 62 (five hours after first dose), (fourteenth day).

72 in the morning (fifteenth day).

75, a little irregular after walking before taking, 84 (one hour after first dose), 86, slightly irregular (one hour and a half after first dose), 100, irregular, but full in the evening (after second dose), (sixteenth day).

natural, but very readily excited (nineteenth day),.

Pulse previous to taking 58, 59 while sitting, 61 standing.

in the afternoon three hours after dinner, 73 while sitting, 78 standing.

at 11 P.M., 82 sitting, 94 standing (first day). in the morning in bed 59.

at 9.30, 72 sitting, 79 standing.

at 10.15, 66 sitting, 85 standing.

while sitting it was strong, full, and regular, while standing, small, weak, irregular, in both rate and strength.

at noon, 65 sitting, 81 standing.

at 11 P.M., 68 sitting, 84 standing, irregular as before (second day).

at 11 A.M., 60 sitting, 72 standing (the slightest motion made it immediately more rapid).

noting the pulse while leaning backward in a reclining clear and then raising myself to slowly sitting upright, the pulse become in a moment jerky and very much smaller and weaker (third day). At 10 A.M., 61 sitting, 65 standing (fourth day),.

Pulse at 11.30 P.M. slower by one or two beats.

in the evening, between 10 and 11.70 while sitting, 82 while standing (first day), at 10 A.M., 75 while sitting, 85 standing.

at 11 A.M., 62 sitting, 71 standing.

twenty minutes after taking 30 drops of the tincture, 64 sitting, 72 standing.

in the evening, 72 sitting, 80 standing (second day).

in the morning, in bed, 70 at 6 P.M., 68 sitting (while at 10 A.M. it was 64), in the evening, 74 while sitting (third day).

at 10 A.M., 58 sitting (fourth day),.

Pulse 80 (before taking).

continued the same for five minutes.

76 (after seven and eight minutes).

78 (after ten minutes).

76 (after twelve minutes).

78 (after fourteen minutes).

80 (after sixteen twenty and twenty-one minutes).

76 (twenty-second to twenty-fifth minute).

78 (after twenty-seven and twenty-nine minutes).

80 (after thirty minutes).

83 (after thirty-two minutes).

84 (after thirty-four minutes).

85 (after thirty-six minutes).

84 (after forty minutes).

80 (after sixty-three minutes),.

When sitting, as well as when walking, worse towards evening and in the evening.

*there was a constant desire to take a very deep breath, but on attempting to do so, it seemed as though the chest could be only half filled, or as though some impediment existed deep in the chest.

there was associated with this a dry cough, especially on deep inspiration, which only seldom expectorated a somewhat hard, lumpy mucus.

in the morning, however, the expectoration was freer and more copious than in the afternoon and evening.

everything seemed too tight about the body.

I was obliged to open my vest and waistband, because their pressure was extremely irksome.

this, however, did not relieve the shortness of breath (fourth day). On the next day, the shortness of breath appeared in a slight degree immediately on rising (the previous evening it had soon disappeared in bed), but was now accompanied by a painful feeling of weariness and general affection of the chest, and a frequent dry cough.

in the afternoon the difficulty of respiration increased, and in the evening it was worse than yesterday, especially while writing (fifth day). On the next day this continued, a little less in the morning, but even more violent in the afternoon and evening than before, even accompanied with some palpitation (sixth day). The next day, the shortness of breath was noticed immediately after rising, though there was no cough and very little expectoration.

in the afternoon and evening it was noticed a little while walking (seventh day).

in the evening walk after this, the shortness of breath continued to return in shorter and slighter attacks, until it gradually disappeared,.

The sensation experienced while vomiting was as if the stomach were contracting with extreme violence as in cramp, much more so than in vomiting in general, and a feeling of soreness continued for some time after.

next day, vomited some bilious matter, liquid, and resembling somewhat yolk of egg, and the crampy contraction was less marked,.

Movings in the intestinal canal, with slight colic (after two hours).

these pains afterwards extended to the lowest portion of the abdomen, into the pubic region, changing into a pressure and dragging, extending down through the pelvic cavity and into the testicles.

after an hour these pains and dragging sensations had disappeared, but in their place occurred frequent urging to urinate, with itching irritation in the glans penis, lasting until into the afternoon (first day),.

Urine of pale straw color and feeble acid reaction.

quantity, 1950 c.c. (previous average, 1475.5 c.c.).

sp. gr., 1013.25 (previous average, 1024.30 c.c.).

total solids, 69.98 grams., of which 31.27 were inorganic, and 38.71 organic matter (previous average, 75.31 grams., of which 37.17 grams. inorganic, and 45.14 organic constituents), (first day),.

Urine, 1125 c.c., acid.

sp. gr., 1025 (first day). 1040 c.c., acid.

sp. gr., 1025 (second day), 1040 c.c., acid.

sp. gr., 1025, very soon becoming turbid (third day). 940 c.c., acid, once in the afternoon neutral.

sp. gr., 1024.6 (fourth day). 900 c.c.

sp. gr., 1025.8. in the afternoon neutral, at other times acid.

in the morning and afternoon after dinner it became very turbid after a few hours, and deposited a thick white sediment (fifth day),.

Urine, 1150 c.c., acid.

sp. gr., 1053 (first day). 870 c.c.

sp. gr., 1023 (second day). 1145 c.c.

sp. gr., 1017.2 (third day). 975 c. c; sp. gr., 1025 (fourth day). 1100 c.c.

sp. gr., 1018.3 (fifth day). 1200 c.c. (once neutral).

sp. gr. 1024.3 (in the forenoon 120 c.c. of weiss beer were taken), (sixth day). 825 c.c.

sp. gr., 1026.9. in the afternoon becoming soon very turbid (seventh day). 1110 c.c.

sp. gr. 1026 (eighth day). 1105 c.c.

sp. gr., 1025.4 (ninth day),.

Awakened twice at night (first night) by urging to urinate, with copious emission of colorless urine.

(on the last evening, instead of beer as usual, I had drunk a cup of tea; tea had never caused such an effect, and it had been taken too early and in too small a quantity; I was still more satisfied that the tea was not the cause, since on the next day I was awakened early in the morning without having drunk tea in the preceding evening;) the desire to urinate was every time accompanied by persistent erections, which frequently occurred in the morning, also during the last three days (thirty-first to thirty-third day),.

With small doses the urine varied just as the pulse had done, being generally increased to a slight extent while I took the drug, but sometimes not, while, with large doses, the diuretic effect was marked.

with the larger doses, especially of the powder, there is a marked increase in the amount of urine before intoxication appears, then a sudden fall during its continuance, and another rise of still greater extent after it has passed off, and after the medicine has been discontinued.

the actual increase in the amount of urine may to some appear small, but when it is considered that the amount of fluid ingested is the same, and that, in a normal condition, very rarely has a large amount of urine been passed on more than two consecutive days, the distinct and persistent diuresis is remarkable,.

Urine seems to be decidedly diminished.

from 4 to 10.30 P.M., passed only once at the latter hour, although much more than usual had been drunk.

even the urine passed in the morning was small in quantity, and the discharge was associated with rather severe urging.

micturition was difficult, and was followed by burning in the urethra and pressure in the region of the bladder.

also in the evening smarting in the urethra was noticed after urinating (tenth day),.

The amount of urine was markedly diminished during the period of intoxication, when the gastro-intestinal canal was most affected.

and in the case of Daniel G., when the pulse was most affected, it fell from an average of between 40 and 50 ounces to 30 ounces, 25, and 26 ounces on the two next days, and 18 ounces on the two following days, again slowly rising for four days, till it rose from 25 to 44 ounces, and then remained at its normal standard,.

Secretion of urine was unchanged for the first three days.

on the second day it was remarkably increased, so that he passed a large amount of watery urine every hour.

next day it returned to the normal (was not diminished in quantity).

the next dose was followed by increased secretion of urine for the whole day (after three or four hours),.

Urine during the first day decidedly diminished (too much so to be accounted for by the warmer weather), 860 c.c., gr. 1025 (aggregate of four evacuations), (first day).

passed in unusually small quantity, and of very high sp. gr. (1033), (second evening).

total amount during the day only 1050 c.c., though I drank 180 c.c. of beer and 210 c.c. of coffee.

in the afternoon the reaction was neutral.

average sp. gr. 1.026.5 (second day),.

GENERAL SYMPTOMS.

Tense white swelling of the whole body, with great painfulness to every touch, after several weeks subsiding, becoming soft, and changing to anasarca,

Bending forward of the body is attended with violent tearing pain in the abdomen, for six days,

Wasting of the body in proportion to the recuperation of the mind,

Universal and partial trembling, for six days,

Convulsions, etc.

Convulsions and great disquietude,

Convulsions of the most violent kind,

Epileptic attacks,

Stiffening of the body, for six days,

The trunk and limbs especially the thighs, are painfully stiff (tenth day),

Relaxation of all the muscles, with sensation as though he had not slept enough,

Sinking of vitality,

Lassitude,

General lassitude, exhaustion, and weariness of body and mind (fourth and fifth days),

The listless state of the body and depression of the mind had increased; the latter was a kind of stupidity (eighteenth day),

Extremely listless and weak (nineteenth and twentieth days),

Weakness sinking of the strength,

General weakness, ,

General weakness, as if all portions of the body were weary (after two hours),

Frequent weakness; she was obliged to lie in bed because sitting up fatigued her,

Great weakness,

Extreme weakness,

Sudden extreme weakness, as if he would lose his consciouness, with general heat and sweat, without thirst, after dinner,

Weak and tired (seventeenth day),

My strength was extremely weakened (fourth day),

Sudden sinking of strength, with general sweat, and after some hours cough,

Could not for several days bear the upright position,

He lay supine, very cold, pale, and covered with copious perspiration (second morning),

Lay on back, and seemed completely prostrated, being scarcely able to move a limb (second day),

Exhaustion (fourth day),

Exhaustion of vitality, with inclination to faint,

Great exhaustion. (fourth day),

Before they had proceeded one hundred yards the poison had taken such effect that one of the sufferers had fallen twice from exhaustion, and on entering their hotel another of them fell senseless,

Extreme prostration (after four days),

Two weeks elapsed before it was possible for me to leave my bed, and nearly two months before health was re-established,

Faintness,

Faintness between the attacks of nausea,

Occasional faintness, which on moving was attended with nausea (third day),

Excessively faint and weak (soon after),

Syncope (soon), ; (after eight hours),

Restlessness,

At night, he leaves his bed every moment and cannot sleep, but converse with persons not present,

Great uneasiness (soon),

Nervous symptoms of all sorts, and great weakness,

Indolence and weariness, in the morning on rising from bed,

Awoke feeling great lassitude and depression; on getting up depression and languor increased (third morning),

Somnolent weariness, slumber,

Feeling of weariness and trembling of the muscles; he was not inclined to leave the bed (second day),

Feeling of great debility (after six hours),

Considerable degree of languor, with vertigo and intermitting pulse,

Much languor and sense of faintness; the patient thinks he cannot endure, but must die,

Extreme languor,

Inclination to faint,

Constant inclination to faint,

Great inclination to faint,

Feeling of great lightness of the body,

Heaviness after first dose,

General malaise (after five hours),

Tearing burning and some itching needle-like stitches in various parts of the body,

Cramps,

General soreness of the whole body,

Bruised feeling,

The small doses up to 30 drops, produced scarcely any effect except a bitter taste and some eructations.

larger doses caused in two persons dryness of the lips, a feeling of rawness or burning in the pharynx, visible increase of saliva and mucus in the mouth, nausea, inclination to vomit, and a constrictive pain in the throat and along the oesophagus, with rumbling or griping in the intestines, and tension caused by flatulence.

the stools remained unaffected in two provers, but in one became very dry and indolent, and in another, after 80 drops, there was sudden diarrhoea. The symptoms from 100 drops and upwards, were pressive pain in the forehead, obscuration of the eyes.

in one case, oppressive pain beneath the ensiform cartilage,.

GENERAL SYMPTOMS.