NAJA.

Naja tripudians.

Class , Reptilia; Order , Squamata; Suborder , Colubrina; Family , Elapidæ.

Preparation , Tincture and triturations.

Authorities. (Nos.

1 to 7 , Dr. Stokes's provings, Br. Journ. of Hom., 11, p. 25, 1853.)

1 , Dr. Stokes, proving by inoculation, some ("a drop at least") of the poison, received on sugar of milk, was made into a paste with water and inserted in the arm; 2 , effects of same preparation on "Rosa," aged nineteen; 3 , Stokes's proving with 2d dil. (6 drops in 3 ounces of water, one dose of half an ounce first day, two doses second day, one ounce fourth day), and 3d dil, fifth, sixth, and seventh days; 4 , same, olfactions of 1st dil. first day, 8-12 globules of 2d dil. second, third, and fourth days, 1 drop of 2d dil. fifth day, 2 drops sixth day, 3 drops tenth day, 6 drops in water seventeenth day; 5 , "Rosa," took 1 drop of 2d dil.; 6 , same, proving two months later, 3 globules of 4th dil. three times a day; 7 , same, four days later, took 6th dil. same way; 8 , Dr. Russell, Br. Journ. of Hom., 11, 593, took 1 grain of 2d dec. dil. daily for six days; 9 , same, three months later, took same doses first, third, fourth, and fifth days; 10 , Georges E. Stewart, aged twenty-four, took 1st dil. night and morning for six days, from Russell; 10 a , same, took 3d dil. night and morning (twelve doses), except fourth night, when he took Camphor; 11 , Dr. Craig, took 2d trit.; two doses of 1 grain each, first, second, third, fourth, and one dose fifth days (took one dose of Bryonia 3d at 6 P.M., fourth day); 11 a , same, took 1st dil. once a day for four days, twice fifth day, and one dose of Bell. sixth day; 11 b , same, took 1st dil., one dose, first and second days, two doses third and fourth days, one dose daily sixth to twelfth day; 12 , W. R., aged twenty-seven, [Symptoms more or less previous to, but only slightly present at time of proving: Skin dry and itching, especially on undressing; chilblains; occasional pimples about chin and back of neck; lips dry; frequent vexed mood, with disposition to find fault; frequent dull, heavy sensation in forehead; sensation as if skull at forehead were too tight; feels thin and starved, worse on waking in morning, and during and after a walk in the air; sensitiveness of scalp (head symptoms less during proving); wings of nose dry and sore; frequent cold in head; eyes yellowish, often bloodshot; uneasiness and fulness in pit of stomach; flatulence; constipation; voice often hoarse; frequent hawking to detach tough mucus that is always swallowed; chest weak; short breath and palpitation on running; frequent oppressive fulness under sternum, as from tough mucus; back weak; a dull aching and numb feeling in lower back, on stooping especially; heaviness of hands and arms; perspires easily; veins of hands swell when hanging down.] took 1 st dil. first, second, third, tenth to fourteenth day; 12 a , same, took repeated doses of 1st and 3d dils. first to seventeenth day; 12 b , same, took 6th dil., twelve doses, in eleven days (has a cold, coryza, cough, and hoarseness); 13 , William Gillow, aged twenty-seven, [Constantly troubled with pityriasis of scalp, with much itching and soreness, worse in hot rooms, etc.; mealy desquamation in other parts of skin; old hæmorrhoids, with extreme pruritus; frequent severe flatulence.] took 1st dil. twice a day for six days (took a dose of Nux v., for symptoms of cold, eighth day); 13 a , same, 1st dil. twice daily for four days, then once daily fifth, sixth, seventh, ninth, and tenth days; 13 b , same, took 2d dil. first day, 3d trit. third and fifth days, 2d dil. seventh day, 1st, two doses, fourteenth and sixteenth days; 14 , Dr. A. C. Pope, [During last few days, bowels costive and irregular; whenever I feel more dyspeptic than usual, I have a slight cough on rising in the morning.] took 1st dil. daily for seven days; 14 a , same, took 3d dil. daily for seven days; 14 b , same, took 6th dil. for seven days; 15 , John Landell aged twenty-six, took 1st dil. daily for seven days; 15 a , same, took 3d dil. daily for seven days, then daily from eleventh to seventeenth day; 15 b , same, took 6th dil. daily for seven days; 16 , Dr. Drysdale (no result from 1st dil.), took 3d dil. for six days; 16 a , same, took 1st dil., new preparation, for six days; 17 , Dr. Russell, too 1st dil. for seven days; 17 a , same, took 1/100 grain of crude first to fourth, seventh, and eighth days; 17 b , same, took 1/100 grain crude every morning for fifteen days; 18 , Mrs. R., aged twenty-seven, [Subject to congestion to the head, profuse menses, leucorrhœa; nursing at time of proving. Since taking N., leucorrhœa entirely disappeared.] took 3d dil. for seven days; 19 , M. C., a woman, aged thirty-eight, took 1st dil. for six days; 19 a , same, took 3d dil. for six days, and again, after six days, for four days; 19 b , same, took 6th dil. for six days; 20 , Dr. Stokes, Month. Hom. Rev., 1859, vol. 3 p. 162, proving on Mr. McSwinney, aged thirty-eight, with 2d dil., 3 to 12 drops daily, for seven days; 21 , (omitted); 22 , Duffin, from Dr. R. Russell (1788), a woman was bitten in leg; 23 , same, second case, a man was bitten in toe; 24 , a man was bitten on the ankle, from Russell; 25 , effects of bite on hand, ibid.; 26 , Gurling, was bitten on nose when partially intoxicated; 27 , Chambers, Glasgow Med. Journ., 1819, effects of bite on back of hand in a woman, from Russell; 28 , Ireland, effects of bite of

Coluber carinatus on hand, Med.-Chir. Trans., 1813, p. 396 29 , same, second case; 30 , same, third case; 31 , Buckland's Curiosities of Nat. Hist., effects of inoculation with poison of the cobra through a raw spot near the nail of a finger used to take off the skin of a rat that had been killed by the snake; ( 32 , omitted); 33 , a woman was bitten on the toe, Hom. Times, 1852, p. 195; 34 , Hom. Times, 1852, p. 194, effects of bite in a man (was walked up and down for three hours and a half, not allowed to stop; he also drank large quantities of brandy); 35 , Dr. Lounds, effects of bite in leg, Month. Journ. of Med. Sci., 1854, p. 136; 36 , Du Chaillu, Am. Hom. Obs., 1869, p. 168, effects of bite in a man; 37 , Fayrer, Thanatophidia, effects of bite in a girl, aged seven; 38 , same, in a man, aged forty-five, death in fifteen minutes; 39 , same, in a man, aged thirty-two, death in three hours; 40 , same, in a boy, aged fifteen, death in ten hours; 41 , same, in a man, aged twenty-five, death in twelve hours; 42 , same, in a man, death in two hours; 43 , same, effects in a woman, Ed. Med. Journ., 1869, p. 425; 44 , same, second case; 45 , Dr. William H. Holcombe, U. S. Med. and Surg. Journ. 1866, p. 234, given to a woman suffering from organic disease of the heart, it produced a new symptom.

MIND

• Emotional.
• Temper good; very excitable and playful, oftener than common (fifth day), 2.
• Is affected easily by a very little wine or alcoholic drink during the week (after three days), 1.
• His mind wandered, but at last he got better, and was able to go out again; a short time after, having an axe in his hand, going, as he said, to cut wood, he suddenly split his own head in two ; he had become insane, 36.
• Very slight emotion, pleasing or otherwise, brings a strong inclination to tears (seventh day), 12a.
• She cried, and seemed to suffer much pain, 37.
• Dulness of spirits (after nine hours and a half, third day), 17.
• Rather dull in spirits, without sufficient cause (second day); great depression of spirits (third day); very low in spirits (fourth day), 8.
• Sense of depression (soon, first day), 17b.
• Considerable depression of spirits, and a feeling of inability to exertion of any kind, and a conviction that all is going wrong; head very painful, and spirits very much depressed (third day), 14a. [10.]
• Great depression of spirits this morning; everything for two or three hours appeared to go wrong with me, and to be without remedy; being called out of town in the afternoon somewhat suddenly, these feelings went off in a great measure, though they did not entirely subside (sixth day); considerable lowness of spirits; great inaptitude for exertion, with sense of aching over the whole head; this continued more or less all day (seventh day); feel to-day very low-spirited; cannot do anything; got better towards evening (eighth day), 14a.
• Great depression of mind, with the distress about the generative organs (fourth day), 13b.
• Sadness or serious disposition (third, fourth, and fifth days); sadness and irresolution (sixth day), 3.
• Intense depression of spirits usually accompanied the headache; this melancholy was of a peculiar kind; I felt that everything that was done was done in a wrong way, and could not be rectified; if I felt that I had some duty to perform, I had at the same time a strong impulse not to do it, and was extremely restless in consequence; I seemed to have an increased perception of what I ought to do, but, at the same time, an unaccountable inclination not to do it, to which I was irresistibly compelled to yield; "I couldn't help it, didn't know why, but couldn't do it." The moral symptoms were not present at all during October; they were very distressing while taking the November packet, and although present, were much less severe in December, .

HEAD

• Confusion and Vertigo.
• Confusion in the head (in less than an hour, and next morning), 25. [30.]
• Slight confused feeling in head (very soon), 10a.
• Vertigo, lasting only a short time, and by and by stounding pain in right side of head (after second powder, third day), 10.
• General Head.
• Considerable congestion to the head at midday (sixth day); increased, with fluid discharge from the nose (seventh day), 12a.
• Head dull (after second dose, third day), 11.
• Dulness in the head (after four hours, fourth day), 10.
• Dulness about head (sixth day), 13.
• Head feels heavy, with vertigo, or rather dull, confused mental state (after two hours), 10.
• Heaviness of head (after one hour), 21.
• Instead of headache, felt rather a dull heaviness (second day), 10.
• A feeling of hollowness over the entire head, which continued for several days, and caused me to leave off further provings (seventh day), 20. [40.]
• Sense of aching over the whole head (seventh day), 14b.
• Headache (eleventh, fifteenth, and sixteenth days), 15a ; in morning (seventh day), 5 ; in evening (first day), 12.
• Passed a very uncomfortable night; slept much, but conscious of a headache (seventh night), 13.
• Slight headache (after second powder), 19b ; (after nine hours and a half, third day), 17 , etc.
• Very slight headache, more or less all day, chiefly frontal and vertical (fourth day), 14b.
• Very slight headache, all day, which was pretty severe and throbbing for a short time, about 3 P.M.; frontal headache (second day), 19.
• "Very bad headache, especially acute over the left eye, just like a scald, for at least an hour," soon after breakfast (fourth day), 19.
• Very bad headache, and stomachache all over (abdomen), at 9 P.M., but probably owing to a jargonel pear, eaten in the former part of evening, not usually so affected by so little fruit (third day), .

EYE

• Objective.
• His eyes stood staring and fixed, 23.
• Eyes wide open and insensible to light, 27. [100.]
• Seemed not to perceive objects, though his eyes were open (after some hours), 25.
• Eyes fixed (after a quarter of an hour), 24.
• Eyes fixed, pupils rather large, acting sluggishly to light (after thirty-five minutes), 26.
• Eyes weak (third day), 18.
• Subjective.
• Eyes felt heavy (fifth day), 14.
• Heaviness and dull pains in the eyes, with suffusion for an hour (two hours and a half after second dose, fourth day), 10.
• Slight heaviness over eyes (fifth day), 13 ; (after six hours, sixth day), 13a.
• Some little weight over eyes (seventeenth day), 13b.
• Heavy aching over eyes (sixth day), 13.
• Oppression across eyes, heaviness in the evening (seventh day), 13. [110.]
• Eyes seem constantly to require cleaning with the lids, frequent prickling, sight confused on looking at small print, etc.; have to rub the eyes and look closely at it (eighth day), 12a.
• Brow.
• Pain in brow (soon, first day), 17b.
• Very fine pricking in left eyebrow (third day), 1.
• Lids.
• Eyelids of the right eye, especially the upper, were swollen and livid, the lividity extending to the right side of the nose (after thirty-five minutes), 26.
• Eyelids puffy in the morning (second day), 5.
• Numb feeling of right lid (first night), 15.
• Heaviness of eyelids (fifteenth day), 15a.
• Heaviness of the eyelids, with difficulty in keeping them open; on examination, found that the edges of the tarsal cartilages had a very livid appearance, in the forenoon (fourth day), 14b.
• Ball.

EAR

• Felt burning of ears, very soon (second day), 4.
• Occasional whizzing sound in one ear (the left), with insipid, almost nauseous taste in mouth (third day), 8.
• Great noise in the ears, as if a mill were going in the head, on waking in the morning (fifth day), 19.

NOSE

• Objective.
• Fluid discharge from the nose, with the congestion to the head (seventh day), 12a.
• Coryza worse, with dull headache over eyes (first night), 15.
• Very severe coryza (third and seventh days, 15b.
• Previous symptoms appeared coupled with a severe cold or influenza, the same being now very prevalent; have desisted from the proving on that account; severe cold in head, fluent coryza in nose and eyes, violent bursting headache, pains in limbs, from the prominent symptoms (ninth day); very bad of same symptoms as yesterday (tenth day), 18.
• Subjective.
• Have felt ever since the forenoon as though a sharp attack of influenza were coming on (fourth day), 14b. [130.]
• Some time in the forenoon I perceived a considerable stuffing of the nostrils to come on, gradually at first, but more rapidly soon afterwards; very much increased in the afternoon and evening, and greatly aggravated by my going out in the evening and walking some distance through the very dense fog; on returning home, a free discharge of thin watery mucus came on, and has continued since; it has afforded considerable relief, being more able to breathe through the nose (fourth day); the stuffing of the nostrils though present, was so in a much less degree than yesterday, all the morning; nostrils were clogged up this evening (fifth day), 14b.
• Nose feels sore, hot, and discharges thin secretion (fourth day), 18.
• Soreness and irritation of the left ala nasi (third day), 14.
• Wing of nostril becoming sore, hot, and tender (twenty-first day); nose worse, swelled and painful; secretion suffused (twenty-second day); nose relieved by an eruption on its edge (twenty-third day), 12a.
• The right nostril is extremely sore, feels as if ulcerated (sixteenth and seventeenth days), 4.

FACE

• Objective.
• Countenance expressed some anxiety (second day), 8b.
• Face flushed, in the evening, and burning hot (first day), 9.
• Face red on rising, and covered with hard knots like in erysipelas; this disappeared after washing (second day), 2.
• Face generally slightly livid (after thirty-five minutes); the lividity had very markedly increased (after forty minutes), 26.
• Face of a greenish-yellow color, 31. [140.]
• Looked very pale and ill (after eleven days), 9.
• Looks thin and haggard in face, dark round eyes (fourth day), 18.
• Subjective.
• Sensation of having caught cold in face and limbs, but without any chilliness of languor; at night, pains in face increased (twelfth day), 12.
• Dull, sticky, deepseated pain in right side of face, for a few minutes (after second powder, third day), 10.
• Cheeks.
• Cheeks red, especially on cheek-bones, patchy (seventh and eighth days), 18.
• Awoke soon after midnight, with gnawing aching in left upper jaw, sometimes shooting to the eye and temple, continued till half an hour after rising; did not occur throughout the day, or only threatened a few times (twelfth day), 12a.
• Lips.
• Lips dry, black pores and cracks (fourth day), 18.
• Lips dry, parched, inclined to crack (seventh day); dry and cracked (eighth day); dry, painful, excoriated (ninth day), 12a.
• Hot sore feeling of the lips (four hours and a half after second powder, fourth day), 10.
• Chin.
• Jaws locked (after a quarter of an hour), 24. [150.]
• Jaw so firmly clenched that the handle of a spoon was called in requisition to force open his mouth, 33.
• Mouth wide open, tongue cold, 27.
• A drawing, painful sensation in the right jaw (after half an hour, fourth day), 8.
• Bruised pain of left condyle, severe when moving jaw (fourth day); soreness of condyle of jaw not so severe (twentieth day), .

MOUTH

• Teeth and Gums.
• Teeth and jaw-bone, left side, begin a gnawing and aching (ninth day), 12a.
• Pains in stumps of decayed teeth, towards evening; at night gums became painful and swelled (twelfth day); teeth loose and gums becoming more swelled and painful, in morning on waking; two hours after rising, gums became hotter, teeth on right side got very loose; gums hot, swelled, and painful to touch (thirteenth day); [Have not had any affection of gums and teeth like above, for twelve months prior.], swelling of gums extending to other side of face (fourteenth day); pains in teeth not much influenced by heat and cold (fifteenth day); mouth still sensitive, and gums swollen (sixteenth day); gnawing aching in sound teeth of left side (seventeenth day); drawing aching in teeth of left side, worse when stomach is empty (eighteenth day), 12.
• Tongue.
• Tongue coated with a thick yellow fur (sixth day), 9.
• Tongue coated white (sixth day), 14b.
• An ulcer on the frænum of the tongue (seventh day), 20.
• Tongue very dry, in the morning; no thirst (third day), 10. [160.]
• At the spot of the tongue where the powder fell, there is a sense of rawness, as if it would rise to a blister (after half an hour, fourth day), 8.
• General Mouth.
• Sore on under lip opposite left canine tooth; gum much swollen and inflamed (seventeenth day); ulcer of lip disappeared in about twelve days after finishing the medicine, 15a.
• Dry mouth; this continued more or less all day (sixth day), 13.
• Dry mouth (second to third day); more than usual dryness of mouth (fifth day), 13.
• Mouth dry on waking in the morning (second day), 10.
• Dry mouth and throat, disagreeable taste, as if breath was offensive (after two hours, fifth day), 13a.
• Mouth very dry (second and third mornings), 13a.
• Great dryness of mouth , frequent expectoration, as if from throat, at 8.30 A.M. (eighth day), 13.
• Clammy mouth, in the morning (second day), 19.
• Acid rawness in the palate all day (fourth day); has increased rather, to-day, and has remained (fifth day); considerable rawness of palate (sixth day), .

THROAT

• Objective.
• Spasms of the throat (after one hour), 21.
• (Secretion in upper part of throat more abundant than usual; very hoarse), (third to fourth day), 12b.
• Accumulation of tough mucus at top of throat (eleventh day), 12b. [190.]
• Great hawking of mucus from throat (seventeenth day), 4.
• Subjective.
• Throat dry on waking (second day), 2.
• Disagreeable feeling in the throat, a good way down, like indigestion, for about two hours (first day), 19b.
• Had complained, it was said, of constriction in the throat, 41.
• Constricted feeling and dryness in throat (after one hour, sixth day), 13a.
• When dozing, I was roused by a sudden sense of choking, a sensation I never experienced in my life before, a sort of grasping of the throat (soon); a few minutes later, felt a sudden jerking of the masseter muscle of the left side (first morning), 8.
• Pressure and gagging in throat , with sad thoughts, for ten minutes, in the morning (eleventh day), 4.
• Has had a sore throat all day, worse since taking the powder (fifteenth day); is subject to an attack of tonsillitis every winter, 19a.
• Awoke with some soreness of the left side of the throat (twelfth day), 11b.
• Rawness in the throat for several hours (fourth day), 19. [200.]
• Feeling of rawness in throat, with slight pinching of stomach (soon), (third day), 17a.
• Slight feeling of rawness in the throat (fifth day), 19.
• Roughness in the throat from reading aloud only a short time (ten minutes after second powder, second day), 10a.
• Sense of scraping in throat (soon), (second night), 17a.
• Scraping sensation in throat, with the hoarseness, towards night; more effort required to swallow than usual (third day); towards night, scraping in the throat, and an accumulation of tenacious secretion at top of throat, inducing frequent inclination to swallow (fourth day); only a slight formation of mucus, easily detached by hawking, and then always swallowed (seventh day), 12a.

STOMACH

• Appetite.
• Appetite failing (ninth day), 12a. [220.]
• Loss of appetite, 9 ; (fifteenth day), 12.
• Craving for stimulants, which aggravate the state (eighth day), 4.
• Great desire for wine (fourth day), 15b.
• Thirst.
• Thirsty (sixth day), 18.
• Very thirsty (seventh and eighth days), 18.
• Eructations.
• Eructations, tasting like barley water, since shortly after taking powder (after four hours), 10.
• Hot, foul risings of air from stomach (fourteenth day), 12.
• Acidity of stomach (seventeenth day), 4.
• Nausea and Vomiting.
• Nausea (fifteenth day), 12 ; (second morning), 20 ; without vomiting (immediately), 21 ; all day (soon), (first day), 17b ; after breakfast and dinner (sixteenth day), 15a.
• Nausea and faintness coming on suddenly, soon after breakfast; removed by acid fruit (second day), 18. [230.]
• Nausea, and a disagreeable sensation in mouth (soon), (third day), 17a.
• Nausea, with very parched mouth, in the evening; frequent inclination to expectorate rather adhesive saliva, yet constant desire to drink, in the evening (seventeenth day), 13.
• Nausea, with pain of stomach and feeling of prostration; a beating in stomach; relieved in open air (twelfth day), 15a.
• Slight nausea (seventh day), 17 ; on going to bed (second day), 13.
• Slight nausea and empty eructations, during the forenoon (first day), 17.
• Sensible of sickness at the stomach, but did not vomit (soon), 25.
• Decided nausea (after the dose, third night and fourth morning), 17a.
• Eat a few walnuts, which caused sickness and pain of stomach; they never hurt me before (fourth day), .

ABDOMEN

• Hypochondria.
• Occasionally, throughout the day, stitchy, evanescent pains from before backwards in both hypochondria; anguishing pain in left hypochondrium and left lumbar region, for an hour or two after taking dinner, and flatulence; aching pains around loins occasionally (second day); after going to bed was very much annoyed for a long time (an hour or more) with aching pain in loins, constant, and with anguishing pain in abdomen, with flatulence (second night), 10.
• Umbilical and Sides.
• Uneasiness about the umbilical region (after a few minutes, first day), 17.
• Frequent sharp, griping pain at umbilical region (fifth day), 17. [260.]
• Occasional twisting pain in umbilical region (first day), 17.
• Frequent cutting in umbilical region and small of back, followed by a rather profuse and sudden leucorrhœa, in the afternoon (second day), 18.
• Griping pain in the left side of the abdomen, for about ten minutes (soon), 9.
• Dull, aching, coliclike pain along left side of abdomen, which lasted for more than an hour, and was relieved after several flatulent eructations (ten minutes after second powder, second day), 10a.
• General Abdomen.
• Swelling in abdomen, with feeling of tightness and flatulence (after second powder, fifth day), 10a.
• Flatulence (second day); considerable flatulence, not so bad as before (third day), 10.
• Troubled with flatulence (first day), also to-day, but not so much (second day), 10.
• For some time past have been troubled with flatulence, and mild, colicky pains in abdomen (fifth night), 10.
• Much flatulence during the course of the day (seventh day), 10.
• Much flatulence, and colicky pains in abdomen (after second powder, sixth day), 10. [270.]
• Rumbling and aching in bowels, after dining (seventeenth day), 12.
• Rumblings and slight cutting pains in bowels, in the afternoon (fourteenth day), 12.
• Uncomfortable sense of emptiness at abdominal region, relieved by folding the arms over it and pressing (fourth day), 18.
• Occasional pains in the bowels throughout the day (fourth day), .

RECTUM AND ANUS

• Feeling of large stool in rectum, which, when voided, was but small (second day), 4.
• Heat in anal region, with itching and smarting at the anus (fourteenth day), 12.

STOOL

• Diarrhœa.
• Bowels more relaxed than usual (fifth, sixth, and seventh days), 18 . [Habitually inclined to costiveness.]
• Infant's bowels relaxed, slimy, white, or green (fifth day); relaxed (sixth, seventh, and eighth days), 18.
• At times, bilious diarrhœa, always preceded by sudden urging, griping pains in the abdomen; the desire to evacuate the bowels, particularly during November (second proving), was always sudden , whether followed by a relaxed stool or not, 14. [300.]
• Very sudden and relaxed motion (after eleven hours and a half, third day), 13.
• When walking in the country, I was suddenly seized with a most urgent desire to evacuate the bowels; the matter was of a light color, and rather watery, and discharged with great force, as if I had taken a powerful cathartic (sixth day); a loose stool, with slight pain in the abdomen (seventh and eighth days); diarrhœic tendency continued, and I still feel uneasy (ninth day); [I am not at all subject to diarrhœa, and I had made no alteration in my food which can in any way account for it.] for two days afterwards, I had no motion in the bowels; the two succeeding days, the motions were partly costive, partly loose, and attended with slight pain in the abdomen. I feel inclined to regard the diarrhœa and costiveness as alternating actions, for on a former occasion it produced a slight tendency to constipation as its primary effect, 9.
• After slight pain in bowels, a rather loose stool with much flatus (after fourteen hours, fourth day), 17.
• Seized with a sudden urging to stool, followed by a comparatively small bilious evacuation (third day), 14a.
• Very bilious small stool in the morning, preceded by sudden urging (sixth day), 14a.
• Constipation.
• Scanty action of bowels. I never fail having a free motion after breakfast; for some days found it rather less, and decidedly so this morning (seventh day); bowels decidedly less effectually moved; evacuations rather hard; passed with distress, and feeling as if more fæces remained (ninth day); evacuation still confined; passed after much straining, and giving very unsatisfactory relief (tenth day), 13a.

URINARY ORGANS

• Uneasiness and pressure in the bladder (sixth night), 3.
• Urine of a deeper yellow color since yesterday noon (second day), 10.
• For the last two mornings noticed the urine thickly loaded with a red sediment, which gathered like a cloud at bottom of vessel, and seemed to be mixed with mucus (fourth day), 17a.
• The urine was thickly loaded with lithates and mucus (first and second provings), 14. [310.]
• The urine has been densely loaded with lithates and mucus ever since commencing the November packets (sixth day), 14a.

SEXUAL ORGANS

• Male.
• Peculiar distress about the generative organs, attended with great depression of mind; sexual desire morbidly strong, yet no physical power (fourth day), 13a.
• After going to bed last night, and this morning, for some time after rising (an hour), felt a stinging, aching, somewhat burning pain along right side of penis, as if immediately under the skin (second day), 10.
• Unusual excitement of genital instinct and power, 12 . [This increase of genitals power has continued, more or less, through the time (after two months and a half).]
• On going to bed, after taking second powder, felt peculiar morbid condition of body and mind; constant violent sexual desire, but with little physical power; thus the night was passed most miserably; frequently waking, with vivid imaginations, and much painful state of mind, involuntary seminal emissions, followed by great prostration and distress; I never felt these symptoms in the same way before (fifth day), 13.
• Female.
• Violent crampy pain in the region of the left ovary, 45.
• In afternoon, leucorrhœa returned for a few hours, thin, whitish (sixth day), 18.

RESPIRATORY ORGANS

• Larynx and Trachea.
• Several times in the course of the day, felt a clogging up of the larynx and trachea with thick mucus, which was hawked up with difficulty (fifth day), 17.
• On getting into bed, felt a tightness in the larynx, and a sensation as though it were stuffed; this was followed, but without much relief, by cough (third night); a similar tightness in the larynx, and also coughed a good deal (fourth day); slight cough and tightness in the throat after getting into bed (fourth night); began to cough, and felt a tightness in the larynx, with a difficulty of swallowing, immediately (fifth day); began to cough, and feel a slight, very slight, tightness in the throat (sixth day); cough, and sense of tightness and fulness in the larynx, immediately, in the evening (seventh day), 14.
• Uneasy constriction or irritation of the larynx, giving rise to a desire to cough without the organic inclination; this returned several times (third day), 8.
• Tickling and teasing constriction at top of larynx increasing, and mucus becoming more tenacious (ninth day), 12a. [320.]
• Irritation in windpipe, and heavy feeling at top of chest (twelfth day), 19a.
• Felt an irritation in the larynx and top of trachea (after a quarter of an hour), which gradually increased in intensity, and still continues; the feeling is like that experienced on inspiring irritating vapor, with a sensation of warmth and rawness, like what I have felt after running fast for a good distance, and it causes a short tickling hoarse cough; hoarseness of speech (after one hour); still the feeling of warmth, etc.; feeling for some time past on a small spot about the centre of left palate like that caused when Aconite is chewed (after two hours); irritation in larynx, but less severe (after four hours); felt well from 1 to 3 or 4 P.M. (after four hours and a half), when irritation in larynx and headache came back, and continues (after nine hours and a half); same kind of sensation in larynx, but not so intense, and it did not continue so long, not above an hour; cough and hoarseness neither so intense nor so enduring as yesterday, soon (second day); scarcely any, if any at all -perhaps it was fancy that made me think there was any- of the sensation in larynx (third day); irritating, raw, rough, pain in windpipe, which increased rapidly and was very annoying, and gave rise to frequent severe, hard cough, which made me quite giddy, and caused a noise in my head and pain in my chest (almost immediately); the raw feeling in larynx, etc., much increased by the cough (fourth day); slight feeling of irritation in windpipe, lasting only a short time (fifth day); slight irritation of larynx and trachea (after first powder); raw feeling and irritation as formerly, pretty strongly marked, with occasional slight cough and hoarseness (after second powder, sixth day); felt irritation in larynx and trachea, this morning on waking, which continued for an hour or more, for half an hour was very hoarse while reading aloud; I thought I was sure of "a cold," having been out in the country, walking fast, and getting wet with rain, but the rapidity with which the hoarseness left, without any apparent cause, leads me to refer it to the medicine (seventh day), .

CHEST. [350.]

• After a considerable fast, feeling of uneasiness about the left chest (after one hour, third day), 11a.
• Once or twice, considerable uneasiness in the upper part of chest, lasting only for a short time (third day), 10.
• After a moderate walk, heat and uneasiness in the left chest, with aching pain, felt particularly about two inches below the middle of the left clavicle (after seven hours, fourth day), 11.
• Most acute pain and sense of oppression at the chest, as though a hot iron had been run in and a hundred weight put on top of it; instantly relieved by hartshorn and water, 31.
• Dull, heavy pain over the lower half of the right chest, with stabbing on taking a deep inspiration; chest not affected by movement, but intensely aggravated by inspiring deeply; the attempt to take a deep breath causes a sudden short, puffing cough; a real cough is impossible, from the stabbing in the lower part of the right chest, in bed; cannot lie for a minute on the left side, but pain and breathing much relieved by lying on the affected side; took one dose of Bryon. 3

(after eleven hours, fourth day). Chest much easier, but cannot expand the lungs without considerable stabbing pains; dulness on percussion, distinct as high as the right nipple, at 8 A.M.; chest comparatively easy, at noon (fifth day). Right chest quite easy; some aching in the left chest in front, at 8 A.M.; the aching sticking in the left chest much worse; it is not so much confined to the base as on the right side, but extends all over, and seems to be more external, at noon; cannot ride, and can scarce walk, with pain in the chest; have to press the left side with the hand, and bend towards that side; on attempting to walk fast, it is as if there was a broken rib tearing the lung; on attempting to breathe deeply, there are horrid lancinations in all directions through the chest, and a short puffing cough; short puffing cough every minute, at 4 P.M.; sticking-aching pain all through the left lung on attempting to breathe deeply; side not affected by motion; respiration 34 per minute (natural 16); cannot lie on the right side; comparatively easy on the affected side, at 11 P.M. (sixth day). Still considerable pain in the left chest, and cough, at 8 A.M. (seventh day). Chest much better; can take a breath and cough without much inconvenience, at 8 A.M. (eighth day). Quite well (ninth day), 11.

• Asthmatic constriction of chest for half an hour, ending in mucous expectoration , in the evening (eighth day), 3.
• Dull aching, contractive pains in chest (after second powder, fourth day), 10.
• Uneasy aching about the chest, particularly the left side, in the evening (ninth day); the uneasiness about the chest always returns in the evening (eleventh day), 11b.
• Hard pressure on chest just above right nipple, in the afternoon (second day), 1.
• Decided pressive pains in left pectoral muscles, for a few minutes in the forenoon (eleventh day), 4. [360.]
• Pain shooting through from the left shoulder-blade (inner and upper angle) to the front of the chest (fourth day), 19.
• Distinct dull shooting in various localities in the left chest (after three hours); chest better (nine hours after second powder, fifth day), 11a.
• In the right side of chest felt a dull, warm pricking in a great multitude of points, over the lower half of front, from fifth rib downwards, with heat extending up the bronchi into pharynx; a hard cough came on immediately, lasting for half an hour, ending in expectoration of a little thick mucus, in the evening; a very peculiar attack (second day), 3.
• (Cold appears to affect the chest more than usual), (third and fourth days), 12b.
• Front.
• Dull pain to the right of the sternum, immediately behind the third rib, passing under the sternum; the spot is tender to touch; chest tight across the upper part (after five hours, fourth day), 11.
• Increased tenderness over sternum, and in throat, all day (sixth day), 20.
• Sides.
• Very violent shooting pain in right side, momentary, but very severe (after second powder, sixth day), 10.
• Mammæ.
• Secretion of milk very much decreased (fourth day); towards evening the milk returned freely (fifth day); scanty (sixth, seventh, and eighth days), 18.
• Occasional pains at top of both mammæ (fourth day), 18.

HEART AND PULSE

• Præcordium.
• Nervous sensation about the heart (fifth day), 17. [370.]
• Feeling of depression and lowness about the heart (eighth day), 4.
• For three days past has felt a want of something about the præcordia; several days ago tried to sing, but had no power to throw out the voice (eighth day), 4.
• Uneasiness about the heart while walking (after three hours, fourth day), 11.
• After riding some distance had considerable pain at the heart, extending through to the left scapula; pain in the chest is not affected by deep inspiration; the above pain lasted some hours, and was very marked (after twelve hours, twelfth day), 11b.
• Complained of a great pain near the heart, 36.
• Heat and uneasy aching about the heart, towards evening (tenth day), 11b.
• A peculiar oppression about the heart, soon (second day), 17a.
• Half an hour after breakfast felt twice, for a minute or two each time, a slight shooting pain in the præcordial region; never felt this pain before (fifth day); it has never returned since (after two months and a half), 14.
• Heart's Action.
• Fluttering of the heart attended the headache (sixth day), 9.
• Whilst writing, had a sudden attack of fluttering at the heart, with rising in the throat (after six hours, first day), 11b. [380.]
• Slight palpitation of the heart, soon (second day), 8.
• Unusual beating of the heart, audible to myself (after three-quarters of an hour), 8.
• Audible beating of the heart (soon, first day), 17b.
• Pulse.
• Pulse 120, regular in rhythm, but unequal in force, most of the beats, however, being tolerably full and strong (after thirty-five minutes); 32, remarkably irregular both in rhythm and in force, some of the beats being strikingly full and bounding (after forty minutes), 26.
• Pulse 98 (natural 60), at 11 P.M. (sixth day), 11.
• Pulse about 96, full (second day), 35.
• Pulse weak and thready, .

NECK AND BACK

• Neck. [390.]
• Tired feel in the cervical and dorsal vertebræ, with the peculiar burning often attendant on exhaustion, all day (first day), 1.
• Dull aching pains in nape of neck (after second powder, sixth day), 10.
• Cutting pains in nape of neck (fifth day), 2.
• Back.
• Rheumatism all night in bed, which has not troubled me for six weeks, feeling in middle of back as if bruised (first night); rheumatism of shoulders again all night (second night); rheumatism (third night), 15.
• Dorsal.
• Pain between the shoulders, as if in the spine, involving afterwards the scapulæ, 17b.
• Pains between the shoulders in the morning on waking, and continuing all day (third day); the pain continues to get worse; it is aggravated by moving the arms (fourth day); till yesterday it continued; it was worse in moving the shoulder-blades, and felt like rheumatism of the muscles of the scapula (seventh day); in the course of the afternoon, felt a dull pain in the region of the spine between the shoulders, much the same in kind and degree as on the fourth day (eighth day), 17a.
• In the course of the day, when busily occupied, my attention was arrested by a heavy dragging sensation in spine between the shoulders; it lasted about half an hour, and was very uneasy (first day), 17b.
• Lumbar.
• Weakness of loins (third day), 15.
• Slight pain in loins, in the morning (fifth day), 19.
• Pain in right lumbar region, similar to what I have often felt after running a distance shortly after a meal, somewhat like that caused by pressing on the testicle, with occasional shootings; a similar feeling spread over the whole abdomen, and to right groin, easier by bending forward (soon after second powder, third day), 10. [400.]
• Severe aching contractive pain in loins and abdomen on going to bed (third night), 10.
• Aching in loins (seventh day), 10.
• Aching in loins, continuous for an hour, and going on now (four hours and a half after second powder, fourth day), 10.
• Acute pain in the small of the back, lasting for two or three hours, in the evening (first day), 19.

EXTREMITIES IN GENERAL

• Felt sudden prostration of strength in limbs , for a quarter of an hour, while walking in the evening (second day), 4.
• Occasional rheumatic-like pains in thighs and arms, and like those yesterday, best marked in shoulder-joints, in the afternoon (second day), 19.
• Awoke with aching in all parts of limbs; two hours after rising all pains in limbs ceased, and a warm glow all over body succeeded (thirteenth day), 12.
• Awoke with the bruised sensation in limbs before felt on the thirteenth day of former proving; all passed off in course of an hour after rising (third day), 12a.
• Dull aching pains in ankle-joints, lower part of thighs, wrist-joints, and shoulder-joints (after second powder, sixth day), 10. [410.]
• Occasional shifting rheumatic-like (drawing-aching) pains in arms, shoulders, and legs, worst on left side, in the course of three hours (immediately after second powder, second day), 10a.
• Right side, drawing, lacerating, for a few minutes at a time, in various parts of limbs, worse by motion, then passing off altogether (first day), 12.

SUPERIOR EXTREMITIES

• Hand and arm of the same side began to swell, and were even mottled (after a few minutes), 30.
• Complained of great aching all up the arm to the shoulder, all day (first day), 2.
• He felt instantly a sharp pain in the part bitten, which soon spread on the palm and upwards on the arm; in less than an hour the hand and wrist-bone considerably swelled, the pain extended nearer the shoulder; the next morning the hand and arm were monstrously swelled, and he complained of pain in the arm; the parts about the punctures mortified first, the gangrene then spread over the back and palm of the hand and part of the wrist, laying the tendons bare, and forming an ulcer of considerable extent, which, however, healed favorably under the usual treatment; it was several months before he recovered the use of his hand, 25.
• Violent acute pain in bitten part, which soon extended to top of arm (immediately), 21.
• Shoulder.
• Shoulder painful (after one hour), 21.
• Rheumatism of shoulders, at night in bed, pain extending to fingers of right hand (first night); slight rheumatism of shoulders (fourth day); slight rheumatism, pains in bed (sixth day), 15a.
• Slight rheumatic pains in shoulders, for some time past (fifth night), 10.
• Rheumatic drawing in left shoulder, in the morning (third day), 1.
• Elbow. [420.]
• Severe drawing-shooting pain in left elbow-joint, in the afternoon (second day), 10.
• Wrist.
• Complained of burning pain in the wrist; hung down his arm, from which a few drops of blood fell, 40.
• Hand.
• Hand and thumb considerably swollen (after one hour), 21.
• Numb pain in hands, and sometimes a feeling like as if ether had been dropped and allowed to evaporate (after second powder, fourth day), 10.
• Crampy pains in palm of left hand and numbness, and shifting rheumatic-like (aching pains), felt especially in shoulder-joints; numbness in hands, as if " sleeping

" (after nine hours and a half), 10.

• Fingers.
• Slight aching in fourth and little finger of right hand, followed in a quarter of an hour by peculiar sensation as of thumbing (fouillement) in the middle of triceps, left arm (after one hour and three-quarters), 1.
• Most acute pain under the nail of the left thumb; [Where the virus had entered.] this pain also ran up the arm, 31.

INFERIOR EXTREMITIES

• Began to stagger in walking (after twenty minutes), 26.
• After first dose, felt a dragging and weariness in the limbs, while walking, with slight frontal headache, which went off after the second dose, 6.
• Pressive and drawing sensations on points in lower limbs and feet, several times (first day), 1.
• Thigh. [430.]
• Slight pain in the anterior part of right thigh, which soon passed off (soon, first day), 17.
• Slight aching in the back part of thighs, in the afternoon, 1.
• Leg.
• Slight vague pain about the muscles of the calf of one leg (sixth day), 16.
• Painful drawing pain in lower part of tendo Achillis, worse by motion (after half an hour), increased to a lameness in a few hours, and passed off in evening, 12.
• Shoots down legs, and tingling in feet (eighth day), 4.
• Foot.
• Chilblains have appeared on both feet within the last three days, very painful, cannot suffer boots on; have not had them before for three or four years (sixth day), 15.

GENERAL SYMPTOMS

• Objective.
• His body became swollen, 36.
• Slight local inflammation, 34.
• He appeared as if much intoxicated (after ten minutes), 28.
• Movements, apparently convulsive, of the mouth and of the limbs were observed (after twenty minutes), 26. [440.]
• He moaned, grasped his throat with some eagerness of action, tossed his head from side to side, and moved his arms and legs in an uneasy, restless manner, not apparently convulsive (after thirty-five minutes), 26.
• Quite stiff and insensible, apparently dying, 33.
• He kept very quiet, staring at his drooping hand, 40.
• He did not get up, but remained where he had been sleeping, groaning, complaining of slight pain in the arm bitten, but altogether unnaturally quiet, 39.
• Considerable depression of mental and physical powers, anxious to do very many things, but not inclined to move about them; feel inclined to huddle up near the fire, and brood over one's business (fourteenth and fifteenth days), 12a.
• During the whole day, depression of vital energies to an unusual degree (first day), 17b.
• Languor (next morning), 25.
• Languid and indifferent during the last few days (ninth day); great languor (tenth and eleventh days), 9.
• Very languid, all morning (eight day), 13.
• He continued many days in a very languid state, 24. [450.]
• Did not recover from the fatigue for some days, 23.
• Unable to support himself in a sitting posture (after thirty-five minutes), 26.
• One natural stool; he was then sufficiently conscious to attempt to it on a pan, and he was supported by two men even during defecation, 40.
• She remained weakly eight or ten days, 22.
• Became weaker and weaker, and then suddenly almost insensible; I found him perfectly insensible (second night), 35.
• Sudden prostration of strength, at night; incapable of either mental or physical exertion for an hour, at 8.30 P.M., then passed off, and became as usual (second day), 12a.
• Rolled about as if very faint and weak, .

SKIN

• Objective. [490.]
• The bitten part on the left ankle bled slightly, the part became dark, and the discoloration spread up the limb, 37.
• The mark of the principal puncture on left upper arm remains livid yet, and looks as if it would long do so (after nine months), 1.
• Hand, arm, and breast of the same side were much swelled, mottled, and of a dark purple, and livid color (after ten minutes), 28.
• On the back of right hand were discovered two punctures, as if made by a needle, about an inch and a half apart, marking the entrance of the fangs; upon each puncture there was a drop of nearly colorless fluid, without any hæmorrhage, tumefaction, or ecchymosis; the wound healed kindly by granulation, 27.
• A pimple on upper lip (second day); pimple on left ala nasi (fifth day), 5.
• Appeared at breakfast with the point of the nose decorated with small papules on a slightly inflamed base; nose sore in consequence (second day); pimples going away from nose (sixth day), 2.
• A large painful pimple on the brow, 17b.
• Neck and body broke out in small white blisters, on an inflamed base; very itchy, passing off in an hour, in the afternoon (fourth day), 6.
• A small boil-like swelling on back of middle phalanx of right hand little finger (tenth day); fades in three days, 4.
• Gangrene of the back and palm of the hand, as well as of the thumb; the tendons were laid bare, and a large ulcer formed, 21.
• Subjective. [500.]
• I think I have felt an itching on various parts of the trunk, after going to bed, these two or three nights; perhaps that may be owing to the Naja (sixth day), 16.
• Creeping itching in various parts of the body, from time to time, requiring them to be scratched (four hours and a half after second powder, fourth day), 10.
• Slight pricking in the wound, 35.
• Fine tingling in legs and feet, while standing (soon), 1.
• For several days, itching and irritation in the cicatrix of an old ulcer up to this day, when it ceases (eighth day), 4.

SLEEP AND DREAMS

• Sleepiness.
• Yawning and lassitude with the headache (sixth day), 15.
• Frequent yawning (fourth day), 19 ; (fourth and sixth day), 15.
• Frequent yawning (after two hours); occasional yawning still, very unusual with me (after four hours), 10.
• Very drowsy, unusually so after tea, slept for an hour; did not make any difference to my night's rest (second day), 14.
• Strong disposition to doze (in less than hour); from this time he himself was for several hours ignorant of what had passed, but from the reports of those about him, he at times showed much inquietude, without making any specific complaint; at other times he lay moaning and dozing; in the morning he had perfectly recovered his senses, 23. [510.]
• In the evening felt very tired and sleepy, and had to retire at 9 o'clock; slept directly after going to bed (first night), 20.
• Strong desire to sleep, and slept for a quarter of an hour, 23.
• Almost invincible desire to sleep, which after three hours' hard walking, accompanied by profuse perspiration, gradually wore off, 34.
• Sleeplessness.
• Little inclination for sleep; the brain appeared irritable (tenth night), 4.
• Have not slept well during the night (fifth night), 15.
• Slept ill in the first part of the night, and had a pretty severe headache (fourteenth night), 19a.
• Sleep broken and disturbed, during the week (after three days), 1.
• Restless night (sixth night), 13.
• Passed a wakeful night, very uncommon with me, and know no reason for it; dreams vivid, waking up very frequently, with very dry mouth ; did not feel ill, but the mind would work constantly and actively; the body not restless (first night); did not feel fatigued as after an ordinary bad night (second day), 13.
• Dreams.
• Dreams during night (sixteenth day), 15a. [520.]
• Many dreams, not disagreeable (sixth night), 19a.
• Long and vivid dreaming at night, little recollection of subjects (sixteenth day), 12.

FEVER

• Chilliness.
• Her body was cold and collapsed, 27.
• Very chilly, from 6 to 8 P.M., could not stay away from the fire, felt better after that (sixth day), 3.
• Chills and partial heats, at 8 P.M.; considerable fever with partial chills, at 11 P.M. (sixth day), 11.
• Feels very cold and uncomfortable (second day), 18.
• Feel starved, cold, and miserable; glad to huddle into bed; offended with the least draft of air (sixteenth day), 12a.
• Extremities cold and corpselike up to upper part of his thighs and arm-pits (second night), 35. [530.]
• Chilly creeping over left foot and leg (after second powder, fourth day), 10.
• Feet and legs cold, hands hot (ninth day), 12a.
• Great coldness of the extremities, particularly the hands (seventh day), 11b.
• Feet very cold all day, unusually so (fourteenth and fifteenth days), 12a.
• Feet very cold and easily chilled, usually very warm; frequent inclination to move the legs, stamp, etc., to keep up circulation (seventh day); feet very cold (eighth day), 12a.
• Very cold feet on going to bed, though I had been sitting in a warm room (second day); cold feet (after one hour and a half, third morning), 13.
• Extreme coldness of the feet (sixth day); coldness of the feet, with aching at the vertex (eighth day), 11b.
• Icy coldness of the left arm and back of hand, cannot keep it warm (eighth day): the coldness affects all the left side, despite all the care to keep it protected; it is rather peculiar, for though the skin feels icy cold to the touch, there is no numbness or stiffness in the joints affected (ninth day); towards night the coldness shifted to the right side, retained the same character, was so bad at night as to hinder sleep for some time (tenth day); symptom mitigated (eleventh day); this peculiar coldness is seldom felt now (twenty-ninth day), 12b.
• Heat.
• Hot skin and pain in a small encysted tumor over the upper part of left acromion process, like the pain in a finger which has been suppurating and is healing (first day), 19.
• He said he felt heated, but refused water before he became insensible, 38.
• Feels uncomfortable and feverish; lips dry, mouth tender and hot (sixth day), .

CONDITIONS

• Aggravation.
• ( Morning ), On waking, headache; eyelids puffy; on waking, noise in ears; dryness of mouth; cough, etc.
• ( Afternoon ), About 3 o'clock, headache.
• ( Evening ), Aching about chest.
• ( Night ), Towards midnight, the symptoms, 21 , coryza; pain in face; hoarseness, etc.; after going to bed, itching.
• ( After going to bed ), Pain in lower back.
• ( After dinner ), Rumbling, etc., in bowels ; griping in abdomen.
• ( After eating ), Pressure in stomach.
• ( Exertion ), Aching across forehead.
• ( Motion ), Aching across forehead; temporal headache; lacerating in limbs; drawing in tendo Achillis.
• ( Stimulants ), The symptoms, 4.
• Amelioration.
• ( Evening ), Mental depression.
• ( Open air ), Pains from temple to temple; temporal headache; nausea, etc.
• ( Walking in open air ), All symptoms, 12 ; aching across forehead.
• ( Alcoholic liquors ), Temporal headache.
• ( Spirits of ammonia ), Pain, etc., at chest.
• ( Acid fruit ), Nausea, etc.
• ( Smoking ), Temporal headache.

SUPPLEMENT: NAJA. Authorities.

46 , Fr. Seevwright, Lond. and Edinb. M. and S. J., March, 1842, p. 257, a child, æt. four years, was bitten on the foot by a cobra manille; 47 , Lancet, 1859 (2), p. 13, woman was bitten on the arm by a cobra.

• Pulse imperceptible at the wrist, ptosis and paralysis of the iris, with profuse diarrhœa; purple sordes on the lips, gums, and tongue, 47.
• Breathing stertorous and difficult; pupils slightly dilated; skin clammy and disagreeable cold; languid, thready, and rapid pulse, 46.