HYOSCYAMUS

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Hyoscyamus is full of convulsions, contractions, trembling, quivering and jerkings of the muscles. Convulsions in vigorous people, coming on with great violence. Convulsions that involve the whole economy, with unconsciousness, coming on in the night. Convulsions in women at the menstrual period ; and then the lesser convulsions of single muscles, and contractions of single muscles. Little jerkings and twitchings. In low forms of the disease it takes on the latter, jerkings and twitchings of muscles. In low typhoid states where there is great prostration with twitching. He feels it himself if conscious enough to realize it, but others see it. An evidence of great prostration of the nervous system. Sliding down in bed, twitching of the muscles. All the muscles tremble and quiver, a constant state of erethism throughout the economy. A state of irritability and excitability. Convulsive jerks of the limbs, so that all sorts of angular motions are made, automatic motions. Choreic motions. But angular motions of the arms, and picking at the bedclothes. Picking at something in delirium. Gradually increasing weakness, whether it be in a continued fever where there has been a delirium or excitement, or in a case of insanity with erethism of the nerves and mind ; excitability and gradually increasing weakness. Complete prostration, so that the patient slides down in bed, until the jaw drops. So the intermingling of jerkings and quiverings and tremblings and weakness and convulsive action of muscles are all striking features. Infants go into convulsions. "Falls suddenly to the ground with cries and convulsions. Convulsions of children, especially from fright. Convulsions after eating." The child becomes sick after eating, vomits and goes into convulsions. "Shrieks and becomes insensible." Goes into convulsions, such as the old books used to say, from worms; and the mother goes into convulsions soon after the child is born, called puerperal convulsions. "Convulsions during sleep. Suffocating spells and convulsions during labor. Toes become spasmodically cramped."

The mental state is really the greatest part of Hyoscyamus. Talking, passive delirium, imaginations, illusions, hallucinations; talking, rousing up and talking with a delirious manifestation, and then stupor. These alternate through complaints. And during sleep talking, crying out in sleep; but, talking and mumbling and soliloquizing. Then, there are wakeful periods, in which there are delirium and illusions and hallucinations all mingled together. Sometimes the patient is in a state of hallucination, and the next minute in a state of illusion. Which means that a part of the time what he sees as hallucinations he believes to be so; and then these hallucinations become delusions. Again, the things he sees he knows are not so, and then they are illusions. But he is full of hallucinations. He sees all sorts of things, indescribable things in his hallucinations. He imagines all sorts of things concerning people, concerning himself, and he gets suspicious. Suspicion runs through acute sickness; it runs through the mania in insanity, Suspicion that his wife is going to poison him; that his wife is untrue to him. Suspicious of everybody. "Refuses to take medicine because it is poisoned." "Imagines that he is pursued, that the people have all turned against him, that his friends are no longer his friends. He carries on conversations with imaginary people." Talks as if he were talking to himself, but he really imagines that someone is sitting by his side, to whom he is talking. Sometimes he talks to dead folks; recalls past events with those that have departed. Calls up a dead sister, or wife, or husband, and enters into conversation just as if the person were present.

Hyoscyamus has another freak in this peculiar mental state. Perhaps there may be a queer kind of paper on the wall, and he lies and looks at it, and if he can possibly turn the figures into rows he will keep busy at that day and night, and he wants a light there so he can put them into rows, and he goes to sleep and dreams about it, and wakes up and goes at it again; it is the same idea. Sometimes he will imagine the things are worms, are vermin, rats, cats, mice, and he is leading them like children lead around their toy wagons just like a child. The mind is working in this; no two alike; perhaps you may never see these identical things described, but you will see something like it that the mind is reveling in, strange and ridiculous things. One patient had a string of bedbugs going up the wall, and he had them tied with a string, and was irritated because he could not make the last one keep up. Hyoscyamus did him a great deal of good. You do not find that expression in the text, but I will speak of it as analogous to the things that belong to the text. He is in alternate states. One minute he raves, and another he scolds in delirium, in excitement; the next he is in a stupor. Finally, in a typhoid state, after he has progressed some time, he passes into quite a profound stupor. Early in the case he can be roused, and he answers questions correctly, and he seems to know what you have said to him; but the instant he finishes the last answer he appears to be sound asleep. Then you shake him and ask him another question, he answers that, and again he is sound asleep. The delirium that belongs to typhoid grows more and more profound, more and more passive, more and more muttering, until he passes into a complete unconsciousness from which he cannot be roused; in which he will lie for days sometimes, and weeks, becoming more and more emaciated; lying there in profound stupor unless this remedy is administered. Lying there picking the bedclothes, and muttering. Even when he is in a stupor and realizes nothing, apparently, that is going on, he makes passive motions, mutters, talks to himself, and once in a while utters a shrill scream. Picking his fingers, just as if he had something in his fingers when there is nothing there. He picks at the bedclothes the same way. Picking at his nightshirt, or picking anything he can get his fingers on. Or, picking in the air, grasping as if he were grasping at flies. This passive delirium goes on until he is in a profound stupor, and lies as one dead. In an insane state it sometimes takes on something of wildness, but not often. It is more passive, talking and prattling, sitting still in one corner and jabbering, or lying down, or going about. "Undertaking to do the usual things, the usual duties." That is, the housewife will want to get up and do the things she is used to doing in the house; the cooper will want to make barrels and the usual things belonging to that business. Wants to carry on the usual occupation in his mind, talks about it, carries on the things of the day, and he keeps busy about it, so it is a busy insanity. Also, the delirium takes on the type of a busy delirium.

Now, to give you something of an idea as to the grading of this general type of insanity it should be compared with Strain, and Bell. You heard in the lecture on Bell. that it is violent, its fever most intense. There is much excitement. In Strain., when we reach that you will see that his delirium, his insanity, is expressed in terms of extreme violence. These three run so close together that something can be brought out by associating them together. When considering Hyoscyamus in its mental state it is well to realize that it seldom has much fever in its insanity. It has a fever sometimes in the low form, but when Hyoscyamus is thought of in relation to a febrile state the intensity of the heat would be this order: Bell., Strain., Hyoscyamus. Now, Bell, is very hot in its mental states. Strain., most violent and active, murderously violent, is moderately hot in its fever, as a rule. Hyoscyamus has a low fever, not very high, sometimes none at all, with its insanity. When one comes to take into consideration the violence of its delirium, or the maniacal actions, then it changes the order. The order as to violence of conduct would be: Strain., Bell., Hyoscyamus. That brings you to see that even when associated with those medicines that look most like it, it is at the bottom of the list. It goes as a passive medicine, while the upper ones are more active. Hyoscyamus has a passive mania. Does not go into violence. That is, the patient will sometimes become murderous, but it is more likely to be suicidal. Sometimes the patient will talk and prattle, sometimes sit and say nothing. "Full of imaginations and hallucinations when asleep and when awake.. Religious turn of mind" with women who have been unusually pious; they take on the delusion that they have sinned away their day of grace. They have done some awful things. "She imagines that she has murdered, that she has done some dreadful thing. She cannot apply the promises that she reads in the Word of God to herself." She will say: "They do not mean me, they do not apply to me, they mean somebody else."

"Thinks he is in the wrong place. Thinks he is not at home. Sees persons who are not and who have not been present. Fears being left alone. Fears poison or being bitten." These phases sometimes take on fear in the sense of fear, but it comes from that suspicion that was spoken of ; lie suspicions or fears these things will take place. He imagines these things are to take place, and hence he is suspicious of all his friends.

Another thing running through the remedy, in insanity and in the delirium of fevers, is a fear of water, fear of running water. Of course, hydrophobia, which is named because of that symptom being a striking feature, has fear of water, but some remedies also have that fear of water. "Anxiety on hearing running water. A fear of water." That runs through Bell., Hyoscyamus, Canth., and, of course, the nosode Hydrophobinum. Strain. has the fear of water. Straw. has the fear of anything that might look like water, shining objects, fire, looking-glass. Fear of things that have in any manner whatever the resemblance of fluids, and hence the sound of fluids. Hydrophobinum has cured "involuntary urination on hearing running water. Involuntary discharge from the bowels on hearing running water." It has cured a chronic diarrhoea when that symptom was present. Hyoscyamus "makes short, abrupt answers to imaginary questions." Imagines that somebody has asked a question, and he answers it; hence, you will find a patient with typhoid fever answering questions that you have not asked. He imagines that persons are in the room and asking him questions. You hear nothing but his answers; .he is in delirium or insane. "Mutters absurd things to himself. Cries out suddenly."

There is another form of his delirium, and there are two phases of this. He wants to go naked; wants to take the clothing off, and this must be analyzed. At first you might not understand that. Hyoscyamus has such sensitive nerves all over the body in the skin that he cannot bear the clothing to touch the skin, and he takes it off. That occurs in insanity and sometimes in delirium, and he has no- idea that he is exposing his body. He appears to be perfectly shameless, but he has no thought of shamelessness, no thought- that he is doing anything unusual, but he does it from the hyperaesthesia of the skin.

There is another phase running through the insanity, which is salacity, and it is violent at times, so violent that nobody but the old doctor can form any conception of the awfulness of it, and the dreadfulness of its effects upon those in the room. With a woman, a wife or a daughter, this state of salacity is manifested in this way: she exposes her genitals to the view of everybody coming into the room. There are instances where in these violent attacks of salacity a woman has gathered her clothing up under her arms to expose her genitals to the doctor as he walked into the room.

"Violent sexual excitement and nymphomania. Obscene things. Speech illustrated by urine, faeces and cow dung," and all sorts of things will come out in this state of insanity and delirium and yet this is only sickness.

"He is violent and beats people. Strikes and bites. Sings constantly and talks hastily. Erotic mania, accompanied by jealousy. Lascivious mania. Sings amorous songs. Lies in bed naked, or wrapped in a skin during summer heat." Not because he is cold, but because of a fancy. Complaints involving any of these mental phases may come on in a young woman from disappointed affections, from coming to the conclusion that the young man in whom she has reposed her confidence has become wholly unworthy of her. It drives her insane, and she may take on any of these phases.

Patients who have come out of continued fevers, convulsions, or insanity have paralytic conditions of the eyes, of the muscles of the eyes. "Disturbances of vision. Far-sightedness. Drawing tension in some of the muscles, and paralysis in others. Strabismus." This is one of the most frequently indicated remedies. The strabismus that comes on from brain disease should be cured with a remedy.

In the Hyoscyamus fevers there is so much brain trouble, and there is left behind a tendency to muscular weakness of the eyes, disturbances of the eyes, and congestion of the retina, and disturbances of vision. Double sight. "Obscuration of vision. Night-blindness. Distorted appearance of the eyes. Spasmodic action of the internal recti." "Pupils dilated and insensible to light." Sometimes contracted, but in these low unconscious states of typhoid it is likely to be dilated. Then again, after he recovers from these low forms of disease there is quivering of the lids, and jerking of the lids,- jerking of the muscles of the eye, so that the eyeball is unsteady. It moves from little spasms of the various muscles of the globe of the eye. All of these symptoms occur either along with the fever, or afterwards. The child goes into convulsions, or has periods of convulsions, where, during -the course of a week or ten days, there have been from fifteen to fifty convulsions, and it may be the convulsions have been remedied with Bell. or Cuprum, or any one of a number of remedies, and afterwards these eye troubles, strabismus and disturbances of vision. "An object looked at jumps." The letters jump while reading. Spasmodic complaints, periodical complaints, paroxysmal complaints of a nervous character will run through the remedy in various regions, and especially in its cough, its stomach troubles and abdominal conditions.

The mouth brings forth a lot of symptoms. The mouth is very dry, "as dry as burnt leather." The tongue tastes like sole leather, because of the dryness. Sometimes the patient will say, "My tongue rattles in my mouth, it is so dry." Very great dryness of the mouth, throat and nose, wherever the mucous membranes are. Dry, cracked, red, will bleed in low forms of typhoid. About the second week, going into the third, the teeth are covered with black blood, lips cracked and bleeding. "Tongue cracked and bleeding. Patient unconscious, except by much shaking or repeated calling he is roused" and slowly puts out that trembling tongue, which is covered with blood, cracks, and is dry. "Sordes on the teeth" in low forms of fever. "Twitching of the muscles of the face upon attempting to put out the tongue." It trembles like it does in Lach., catches on to the teeth from its great dryness, and the jaw hangs down, -relaxed, the mouth wide open. The whole mouth is dry and offensive. Sometimes during fever the jaw becomes fixed as if it were locked, and it is with great difficulty that it can be moved. "Closes the teeth tightly together. Pulsating pains in the teeth. Jerking, throbbing, tearing in the teeth. Sordes on the teeth;" and in sleep in these low forms of fever he is grinding the teeth. Children, either in convulsions, or between convulsions, in congestion, also grind the -teeth in the night, and in this comatose state. It says in the text, "The tongue is red, brown, dry, cracked, hard. Looks like burnt leather. The tongue does not obey the will. Difficult motion of the tongue; it -is stiff, protruded with great difficulty. Biting the tongue in- talking." The tongue becomes paralyzed. "Loss of speech. Utters inarticulate sounds. Speech embarrassed. Talks with difficulty." The muscles of the throat, of the tongue, those that take part in swallowing, the muscles of the oesophagus, of the pharynx, become stiff and paralyzed so that swallowing is difficult. "Food taken into the throat comes up into the nose." Fluids come out of the nose, or go down into the larynx. "The sight of water, or the hearing of running water, or the attempt to swallow water produces spasmodic constriction of the oesophagus."

The next very important feature of this medicine is its stomach and abdominal symptoms. Vomiting. Dread of water. Unquenchable thirst. Aversion to water, as it were, from the stomach; a mental fear of water. The stomach is distended. Great pain in the stomach. Dryness evidently in the stomach like there is in the mouth, because it-occurs along with it. Burning and smarting in the stomach; and when there is no inflammation there is vomiting of blood. Stitching pains, colicky pains, distension. The distension of the whole abdomen. "Abdomen wonderfully distended, almost to bursting." Feels like a drum, tympanitic. "Great soreness ; can hardly- touch the abdomen because of the soreness. Cannot be handled, cannot be turned except with great difficulty, very slowly, and with caution. Cutting pains in the abdomen." Inflammation of all the viscera of the abdomen in low typhoid state, with great distension. Petechia upon the abdomen, such as is found in a typhoid.

Then comes the diarrhoea, very much like that which is found in low forms of continued fever. "Bleeding from the bowels; ulceration of Peyer's glands," and the yellow, cornmeal mushy stool. In Hyoscyamus there is that mushy stool that occurs in typhoid fever, poppy consistency. Again, a watery, horribly offensive, bloody fluid. Most of the time the stools and the passages are painless. "Painless discharges from the bowels. Watery mucus, sometimes odorless, but commonly very offensive." Then, another part of it is that the patient has no realization of the passage. It is involuntary. Both the urine and the stool are passed without his knowledge. Watery, bloody, or mushy. Hysterical females and young girls, who are subject to attacks of diarrhoea and bloody stools. Relaxed state of the bowels connected with relaxation of the uterus. "Diarrhoea during pregnancy. Diarrhoea during typhoid fever. Paralysis of the sphincter ani. Paralysis of the bladder after labor, so that the urine remains in the bladder, with no desire to urinate." The routine remedy for retention of urine after labor is Caust. Caust., like Rhus, is a great remedy for the effect of strain upon muscles and parts, and the violent effort that a woman passes through in expelling the child in many instances leaves all the pelvic muscles tired, relaxed, paralyzed.

Then comes that which was mentioned, which really belongs to the general state more than the local; violent- sexual desire. Violent sexual desire in girls who never had that desire. Coming on and manifesting itself only during the inflammation of the brain.

"Labor-like pains from taking cold." A cold settles in the uterus, bringing on painful menstruation. Hyoscyamus has various .crampings; cramps in the fingers and toes and of the muscles here and there; temporary paralysis, etc. It has suppressed menstruation. There are many conditions belonging to menstruation, pregnancy and parturition that are hysterical in character. Twitchings, cough, constipation diarrhoea, etc., that belong to a hysterical nature. "Puerperal convulsions. Jerks violently at the oncoming of the convulsions. After miscarriage, haemorrhage of bright red blood. No desire of the bladder to expel the contents."

And then comes the voice, the larynx, respiration, and cough. Constriction of the larynx. Much mucus in the larynx and air passages, makes the speech and voice rough. Hoarseness with dry and inflamed throat. Speech difficult. Hysterical aphonia. Hyoscyamus and Veratrum are two medicines that cure and make a nervous hysterical woman a great deal more sensible.

"Difficult spasmodic respiration from spasms of the chest. Apparently loss of breath; rattling in the chest." Hysterical cough. Sensitive, hysterical girls; or sensitive women, with spinal irritation, have paroxysmal cough, coming on periodically, coming on from excitement. When this patient lies down in the daytime, at night, any time; on will come the spasmodic cough with contractions in the larynx, spasms in the larynx, choking, gagging, and vomiting. "Redness of the face, and suffocation." It is a dry, hacking, choking cough, that racks the whole body, in spinal affections. "Tickling in the larynx. Dry, hacking, and spasmodic cough, worse lying, better sitting, worse at night, after eating, drinking, talking and singing. Dry, spasmodic, persistent cough." But its characteristic cough is a dry, racking, harassing cough, worse lying down. Those young women and girls with sore spots on the spine from the coccyx to the brain, sore places that manifest themselves when leaning back against a chair. These take a little cold in the larynx, and sometimes it is purely from a nervous attack. Sometimes spinal irritation, spinal cough in those that have curvature of the spine. "During cough, spasms in the larynx. Cough worse after midnight; wakes the patient from sleep. Cough in cold air, and from eating and drinking. Cough after measles. Violent spasmodic cough." The cough is most exhausting. A cough will sometimes last until the patient is covered with sweat and is exhausted, and leans forward -to get a little relief; and he coughs until he is exhausted." Spasms of the muscles of the chest. Contraction of the muscles of one side of the neck. Spinal meningitis with convulsions."

Paralytic weakness of the limbs. Convulsions of the muscles. Twitching. Frequent twitchings of the muscles of the hands and feet. Many complaints come on during -sleep. The sleep is a great tribulation to this nervous patient. There are times of sleeplessness.

Again, profound sleep. "Sleepless, or constant sleep." Either awake or asleep, there may be muttering. "Long continued sleeplessness. Lascivious dreams. Lying on the back he suddenly sits up and then lies down again." That means that the patient wakes out of sleep, looks all around, wonders what terrible thing he has been dreaming about; his dream seems real. He looks all about and sees nothing of the objects of his dream, he lies down and goes to sleep again. He keeps doing that all night. Starts up in a fright. Jerks in sleep, and cries out. Grates the teeth. Laughing during sleep. With so much brain trouble as belongs to this medicine, we would expect the dreams and the f right, the disturbances, the twitching and trembling in sleep. Its fevers are low forms of fever, the continued fever, the typhoid.