HYDROCYANIC ACID.
By Timothy F. Allen — The Encyclopedia of Pure Materia Medica
Acidum hydrocyanicum. Hydrocianic or Prussic acid; (Germ.), Blausäure.
The pure acid should be preserved in a 2 per cent. aqueous solution; this is the officinal acid, and is to be considered the matrix.
Preparation for use , Dilutions with alcohol.
Authorities. ( 1 to 5 , provings by Jörg and his pupils).
1 , Assmann, proving of acid prepared after Vauquelin's method, 1 drop, morning, 2 drops at 3 P.M. first day, 3 drops second day; 1 a , same, proving of acid prepared after method of Ittner and Brandes (from Ferrocyanide of potassium and Phosphoric acid), 2 drops first day, 3 drops second day; 2 , Heisterbergh, proving of Vauquelin's acid, half a drop first day, 1 drop in morning and 2 drops in afternoon second day, 3 drops third day; 2 a , same, Ittner's acid; 3 , Kneschke, proving with Vauquelin's acid; 3 a , same, with Inner's acid; 4 , Otto, proving with Vauquelin's acid; 4 a , same, with Ittner's acid; 5 , Jörg, proving with Vauquelin's acid; ( 6 to 25 , except 16, 17, 19 and 20 , from Hartlaub and Trinks's "Laurocerasus," Mat. Med., 1, p. 127); 6 , Symptoms by Hartlaub; 7 , omitted; 8 , Hufeland's Journ., 52, 2, p. 56; 9 , Granville, Lond. Med. and Phys. Journ., Sept., 1826; 10 , Roch, die Anwend. d. Blaussäure, Leipzig, 1827, 8; 11 , G. A. Richter, Arzneim., II, p. 512; 12 , Toulmouche, Rév. Méd. Franç. et étrang. et Journ. d. Clin. de l'Hôtel Dieu, I, pp. 265-274; 13 , Hufeland's Journ., 1823, pt. 7, effects of 2 scruples of Ittner's acid in half an ounce of water; 14 , Ann. de Chim. Oct. 1814, tom. 92; 15 , Manzoni, de precip. acid Pruss., etc., effects of fumes; 16 , Ittner, effects of inhalation, Beit. z. Gesch. d. Blaussäure, 1809 (from Preyer's monograph, 1870); 17 , Gilbert, Annal., vol. 53, p. 217 (from Preyer's monograph), effects on a man; 18 , Magendie, Vorschr. z. Bereit. und Anwend., etc., 1826; 19 , Adlemann, rhein. Jahrb. 1 suppl., 1822 (from Frank's Mag., 3, p. 5), a man took 6 drops four times a day for pain in abdomen, after some days he took a double dose and felt effects; 20 , Coullon, Recherch. et Consid. Méd. sur l'acide hydrocyan., Paris, 1819, p. 128 (from Preyer's monograph, 1870), effects of inhalation, and in one case of 20 to 80 drops (!) internally; 21 , Hecker, Arznm., I, p. 309; 22 , Brera, reference omitted; 23 , G. A. Müller, ibid.; 24 , Neue Samml. aus. Abh. f. p. Aerzt.; 25 , Horn, Archiv., 1818, p. 510; 26 , Schneider, effects of inhalation (from Preyer); 27 , Wedemeyer, 1817, effects of 1 drop of 9 p. c. solution (from Preyer); 28 , Elwert, 1821, experiments (from Preyer); 29 , Robriquet, 1831, effects of moistening the tips of the fingers, with a 2 p. c. solution (Preyer); 30 , Preyer, monograph on Blausäure, 1870, effects of inhalation on himself; 31 , Robert (from Preyer); 32 , Bertin, case of poisoning by a teaspoonful of a 3 p. c. solution, Horn's Archiv., 1825; 33 , Baumgaertner, Med. Zeit., 1829 (Frank's Mag., 4, p. 5), a man suffering from hæmoptysis took too strong a dose (a few drops with ammonia); 34 , Hufeland's Journ., 1815 (Frank's Mag., 2, 558), a woman took about 40 grains of strong acid; 35 , Sandras, Recueil period., 110, 1830, general effects of too large doses on various patients; 36 , Andreessen, de ven. acid hydrocyan., Berlin, 1829 (from Roth's Mat. Med.); 37 , Gendrin, Journ. Gen., vol. 103, p. 367, ibid.; 38 , N. Eng. Med. Journ., 1821, p. 21, effects on a young lady suffering from phthisis pulm.; 39 , ibid., on a lady of 20 suffering from catarrh and chronic cough; 40 , ibid., on a child of 8 with hooping-cough; 41 , Geoghegan, Dublin Med. Journ., 1835, p. 309, a man suffering from uneasiness in stomach took doses of the acid according to Dublin Pharmacop. (sp. gr .998), increasing to 2 drachms on the sixth day; 42 , same, experiments of Dr. Prout; 43 , Banks, Edin. Med. and Surg. Jour., 1837, p. 44, a girl of 19, suffering from indigestion, took more than 30 drops; 44 , Smith, Lancet, 1844, p. 335 a girl of 8 took oil of bitter almonds (about 10 to 15 drops); 45 , omitted; 46 , Garson, Edin. M. and S. J., 1843, p. 72, a man took an overdose of Hydrocyan. acid; 47 , Taylor, Lond. Med. Gaz., 1845, p. 103, a man took 45 drops of Scheele's acid; 48 , Nunneley, Provincial Med. and Surg. J., 1845, p. 561, a man took an overdose of Scheele's acid; 49 , Letheby, Pharm. Journ., 4, p. 511, a girl, aged 22, took les than a grain of the pure acid; 50 , Hempel's Mat. Med., from Rév. Méd., a physician experimented with diluted acid; 51 , Bishop, a man took about 1 1/2 grains of pure acid, Lancet, 1845, p. 31 5; 52 , Godfrey, Lond. and Ed. Month. Journ., 1845, p. 711, a man took an overdose; 53 , Hicks, Lond. Med. Gaz., 1845, p. 462, a girl took 1 ounce of Scheele's acid; 54 , same, a woman took an overdose; 55 , Champneys, Lond. and Ed. Month. J., 1845, p. 708, a woman was poisoned by it; 56 , Pooley, Lond. Med. Gaz., vol. 35, p. 859, a man was found with an ounce vial half full of Scheele's acid; 57 , Hoyn, Chemist., vol. 4, p. 421, a man drank about 45 grammes of hydrate of cherry laurel; 58 , Lond. Times and Gaz., 1858, p. 36, a woman poisoned by an overdose; 59 , Christison, Edin. Month. Journ., 1850, p. 97, a man, aged 60, poisoned; 60 , Regnault (Ann. d'Hyg.), B. and F. Med.-Chir. Rev., 1852, p. 418, a medical student poisoned by vapor; 61 , Barker, Br. Med. J., 1861, p. 655, a boy took almond flavor; 62 , Perry, Br. Med. Journ., Jan. 1862, a man committed suicide (scarcely a grain taken); 63 , Hickman, Lancet, 1866, p. 310, a man took half an ounce; 64 , omitted; 65 , Hall, Am. J. Med. Sc., 1868, p. 277, a man took about 100 drops of a 2 p. c. solution (death in twenty minutes); 66 , Stevenson, Guy's hosp. Rep., 1869, p. 259, a man took about 1 1/2 drachms of Scheele's acid; 67 , Thomas, Lancet, 1873, p. 522, a man took about an ounce of ordinary acid of the Pharmacop; 68 , Madden and Hughes, Br. J. of Hom., 20, p. 453, Sir Benj. Brodie applied a drop of oil of bitter almonds to his tongue.
MIND
- Emotional.
- After venesection, wild delirium, with constant tossing from side to side, biting at the bystanders, protruding anxious eyes, small pupils, heart and pulse rapid, 23.
- She exclaimed, "Bread, bread," immediately, and sprang convulsively from her seat, 43.
- Much disconnected talking, 33.
- Occasionally moaning (after about twenty minutes), 46.
- Groaned (after about twenty minutes), 46.
- Gloominess and ill-humor, in the afternoon (second day), 5.
- Anxiety, 20.
- Anxious feeling, 8.
- Fretfulness (second day), 1a. [10.]
- Loss of courage, 6.
- Fear of imaginary troubles, 9.
- Intellectual.
- At first the patient made quick answers, but soon became heavy, 33.
- Thought difficult (second day), 4a.
- Inability to collect the thoughts, 9.
- Complete inability to think, 6.
- Memory very weak, 6.
- Unconscious (within five minutes), 65.
- Loss of consciousness, 36.*
- Loss of consciousness, lasting two hours and a half, 12. [20.]
- Loss of consciousness, with great weakness, 13.
- Sudden loss of consciousness and sensation, 50.
- Complete loss of consciousness, 37.*
- Stupefaction, 31 ; (from the fumes), 14 ; (after four minutes, third day), 3.
- He was in a state of coma and perfectly insensible, 62.
- Extreme coma for four hours and a half, only interrupted by occasional sudden convulsive movements, 60.
HEAD
- Confusion and Vertigo.
- Confusion of the head, 10, 20, 30 ; (after a few minutes), 1 ; (second day), 5.
- Confusion of the whole head (soon), 1.
- Confusion of the whole head, accompanied at first by transient vertigo (soon), 3.
- Confusion in the forehead and dull feeling of pain (first day), 1a. [30.]
- Confusion of the right side of the head, accompanied by slight pressure in the occiput and forehead of the same side (after three minutes, second day), 3.
- General confusion of the head, 1a.
- Slight confusion of the head (after a few minutes), 3a.
- Slight confusion of the head on the right side, extending from the occiput forward, and causing slight pressure in the frontal region (first day), 3.
- Considerable confusion of the head, together with acute pressure in the forehead and occiput, worse on the right side, most violent in the region of the right eyebrow (third day), 3a.
- Great confusion of the whole head, in the forehead and occiput (third day), 3.
- Having walked a few paces he experienced a feeling of great confusion, with headache and loud ringing in his ears (after two minutes); he now with difficulty retraced his steps, and leaning forward on a table became insensible and fell backwards; in this state he remained altogether between three and four minutes, during which time he was violently convulsed, and, to use the expression of those present, affected like a rabbit poisoned with the acid (sixth day), 41.
- Uneasy confusion in the head; he turned around, spoke a few words, and immediately fell down; the teeth were tightly clenched, 32.
- Vertigo, 19, 35 ; (from the fumes), 15.
- Vertigo, continuing through the day (third day), 3a. [40.]
- Vertigo, lasting eight days, 16.
- Vertigo; objects about him seemed to be moving (after four minutes, third day), 3.
- Vertigo, so that he could scarcely keep upon his feet, 17.
- Vertigo and obscuration of the senses, 11.
EYE
- Objective.
- Eyes brilliant, 55.
- The eye had a brilliant and glassy appearance throughout; mere physical brilliancy, without mental expression, 44.
- Eyes bright, prominent, and glassy, and the pupils dilated (after five minutes), 61.
- Eyes glassy, 48. [90.]
- Eyes of almost natural appearance, dull rather than bright; not prominent; pupils large, 52.
- Eyes staring and fixed, almost immediately; fixed and glistening (after quarter of an hour), 43.
- Eyes prominent and staring, 48.
- Eyes prominent, fixed, and staring (after five or ten minutes), 58.
- Eyes half closed, but prominent and glistening, with their pupils widely dilated, and quite insensible to light, 49.
- Distortion of the eyes, 13.*
- Eyes fixed, 55 ; (after twenty minutes), 46.
- Eyes fixed and closed, and the pupil somewhat dilated, 63.
- Eyes fixed, but lifelike, the pupils in their normal condition (after five minutes); at the moment of dissolution the pupil of eye dilated, 45.
- Eyes seem immovable and involuntarily directed at one point (after quarter of an hour), 4.
- Subjective. [100.]
- Pain deep in the eyes and temples, and then in the occiput, 33.
- Severe pressure, especially over the right inner canthus (third day), 3.
- Brow.
- (Pain above the left eye), 35.
- Lids.
- Small varicose veins in the eyelids, 33.
- Open eyes, with fixed eyeballs, 36.*
- Eyes open; eyeballs turned upward, 46.
- Eyes wide open, fixed, and glazed; pupils widely dilated (after eight or nine minutes), 51.
- Eyes wide open, staring straight forward upon vacancy, injected, watery, and with the pupils somewhat contracted, but not more so than they are naturally in persons of his age (after one hour), .
EAR
- Ringing in the ears, 35.
- Loud ringing in his ears after two minutes (sixth day), 41.
- Roaring in the ears, 35.
NOSE
- A peculiar sensation in the upper nasal cavities; it seems as though mephitic air passed through them over the Schneiderian membrane, and caused a pricking feeling for a short time (after one hour, first day), 4.
FACE
- Wild-looking and bloated countenance, 50. [140.]
- Appeared like a man suffering from an excess of drink, 48.
- It makes the lines of the face very distinct, 11.
- Face flushed, 46.
- Face and neck red and puffy, 32.
- Face bluish-red and swollen (after five or ten minutes), 58.
- Bloodvessels injected, and the whole countenance bloated, 48.
- Face and head congested and hot (after one hour), 59.
- His face, previously pallid, became greatly congested, and the veins large and prominent, 63.
- Face so greatly congested as to be almost purple, 54.
- The countenance had a dusky appearance, 55. [150.]
- Face blue, 66.
- Slight cyanosis of the face, 60.
- Color of the face very gray and earthy, 6.
- Almost black in the face (after two or three minutes); countenance of a ghastly, pale appearance; his face, however, much swollen, and covered with large drops of perspiration (after eight or nine minutes), 51.
- Very pale (after five minutes), 61.
- Face swollen, 12.
- Whole face swollen, turgid, and almost purple from congestion, 49.
- Countenance puffed up and dark, rather purple, 48.
- Face sunken, 6.
- Face sunken, pale, 34.
- Lips. [160.]
- Pale, bluish lips, 36.
- Distortion of the mouth, 32, 50.
- Chin.
- The only symptom of life was a slight movement of the lower jaw, 55.
- Jaw fixed, 48.
- Jaws fixed, the teeth of the inferior retracted within those of the superior, 46.
- Jaws clenched, 49, 66.
MOUTH
- Tongue.
- Tongue coated, 6.
- Tongue white and somewhat dry, 6.
- Tongue slightly protruding, 52.
- Sensation of numbness of the tongue (from local application), 27.
- Feeling of coldness on the tongue, 15.
- A feeling in the root of the tongue as though it were drawn together from both sides (soon), (second day), 5. [180.]
- A peculiar irritation at the root of the tongue, which soon became a scraping feeling like that caused by eating dry walnuts (after quarter of an hour, first day), 4.
- General Mouth.
- Dryness of the mouth, 35.
- Mouth very dry, before and after dinner (second day), 5.
- Violent scraping in the soft palate, 30.
- Saliva.
- Salivation, with two or three slight attacks of nausea, lasting several minutes, 20.
- Causes spitting, 31.
- He was obliged to spit for several minutes, 17.
- Foam issuing from the mouth, 54.
- Mouth covered with foam, 49.
- Froth at the mouth, 37. [190.]
- Frothy mucus exuded from the lips, 63.
- On raising her up a little, some froth came out of her mouth, 55.
- Froth appeared at the mouth, forming large bubbles; this fluid was so viscid that it could scarcely be wiped away, 66.
- Thick salivary froth tinged with blood (bloody appearance caused by her biting her tongue) issued from her mouth (after five or ten minutes), 58.
- A small quantity of brownish tenacious matter had fallen from his mouth on to the blankets, 46.
- Taste.
- Sweetish taste on the tongue, 15.
- Extreme bitterness in the mouth (immediately), (sixth day), 41.
- Sharp irritating taste, .
THROAT
- Drink rumbles audibly through the throat and intestines, 6.
- He appeared to have considerable uneasiness in the throat, but could swallow (after five minutes), 61.
- Heat about the throat (after four hours), 46.
- Sore throat, which hindered deglutition; saliva being abundant, and flowing out of the mouth, in the evening, 46.
- Scraping in the throat, lasting till noon (first day), 4.
- Scraping in the throat, with a peculiar tickling irritation extending from the pharynx low down the air-passages, and causing an inclination to a frequent hacking cough; this condition of the air-passages was compared to that after taking cold when one is hoarse, or to that which is caused by eating hips of roses when little hairs stick in the throat; in the evening this irritable condition changed to a very decided dryness in the mouth and larynx (second day), 4.
- Scraping sensation in the throat, accompanied by some transient stitches and increased secretion of mucus, which compels frequent expectoration of thin saliva (third day), 4a.
- Slight scraping in the throat (after one hour, second day), 3.
- Scraping in the throat, very slight (first day), 2a. [210.]
- Distressing scraping in the throat, like that caused by eating too many walnuts (second day), 3.
- Fauces, Pharynx, and Œsophagus.
- Pain, heat, cramp in the fauces, œsophagus, and stomach, 22.
- Scraping in the pharynx (after three drops), 2.
- Warmth in the œsophagus, 35.
- Swallowing.
- Unable to swallow (soon), 43.
- An attempt was made to make him swallow; but although a movement of deglutition was distinctly noticed once or twice, the fluid remained in great part in his mouth, ebbing and flowing with the respiratory movements, 66.
- External Throat.
- Bloating of the neck, 50.
- Considerable swelling of and undulatory motion in the jugular veins; the carotids beat quickly and fully, 44.
STOMACH
- Appetite.
- Increased hunger, with aversion to food (second day), 1a.
- Diminished appetite and digestion, 11. [220.]
- Loss of appetite, 33, 35 ; (second day), 1a.
- Loss of appetite, for eighteen days, 6.
- Appetite for the first hour completely wanting, but afterwards unusually increased, 1.
- Aversion to eating, 9.
- Thirst.
- Thirst (after four hours), 46.
- Eructation and Hiccough.
- Eructations tasting of the drug (second day), 1a.
- Evolution of gas from the mouth of the odor and taste of the drug, 12.
- Violent hiccough, which lasted almost an hour, did not yield to the usual remedies, such as holding the breath a long time, etc., but disappeared after a cup of black coffee (second day), 1a.
- Heartburn and waterbrash, with accumulation of much saliva in the mouth, after eating (second day), 1a.
- Nausea and Vomiting.
- Nausea and vomiting, with relief of the symptoms, 16. [230.]
- Vomiting, 19, 33 ; (sixth day), 41.
- Vomited frequently during the day, 46.
- Vomiting of black liquid, 12.
- Vomited a blackish mucus (the fauces being tickled with a feather), 50.
- Stomach.
- Region of stomach distended, 50.
- Warmth in the stomach, 35.
- Disturbances of the stomach, 21.
- Discomfort, with nausea, after eating (second day), 1a.
- Remarkable and unpleasant sensation at the epigastrium, with such weakness in the limbs and loss of power in the muscles that he thought he should have fallen; quite momentary (immediately), 68.
- Feeling of a lump in the stomach, gradually changing to a sticking pain, which, after lasting a short time, left behind a sensation of pressure (second day), . [240.]
ABDOMEN
- Feeling as if the spleen were enlarged (during the first days), 16.
- Rumbling in the abdomen, 35 ; (third day), 4a.
STOOL
- Involuntary excretion of stools (after three hours), 57.
- Involuntary discharge of stool and urine, 23.
- Discharge of fæces in the bed, 33.
- The usual stool did not occur (first day), 2a.
URINARY ORGANS
- Burning in the urethra, during micturition (third day), 3.
- Profuse discharge of watery urine (third day), 3.
- The activity of the kidneys seemed increased; the urine had a normal relation to the amount of drink, but was passed at shorter intervals than usual (second day), 4. [250.]
- Involuntary excretion of urine (after three hours), 57.
- Retention of urine for four days, 12.
- Greatly increased secretion of urine and perspiration from the skin, 11.
- Urine saturated; more copious than usual (third day), 4a.
SEXUAL ORGANS
RESPIRATORY ORGANS
- Larynx.
- Scraping in the air-passages, soon, 1.
- Feeling as though the larynx were enlarged or swollen (fourth day), 4.
- Spasmodic constriction of the larynx, 17 ; with hawking (from the fumes), 14.
- Rawness and scraping in the larynx, 2a. [260.]
- Scraping in the larynx (soon), 1 ; (second day), 5.
- Scraping in the larynx, together with sticking, leaving a feeling as though the larynx were swollen and too narrow, and as if it pressed against the neighboring parts; swallowing of food and drinks however was not difficult nor painful (second day), 4a.
- Scraping sensation in the larynx (first day), 1a.
- Scraping irritation in the larynx (after ten minutes), 4a.
- Tickling and scraping in the larynx, causing a frequent dry cough (soon), (second day), 1a.
- Voice.
- Voice hoarse but distinct, 57.
- Cough and Expectoration.
- Cough, 15.
- Frequent cough, in the evening, 46.
- Violent cough (immediately), 26.
- Paroxysms of cough with expectoration of black yellowish mucus, with relief of the rattling respiration, 32. [270.]
- Greater secretion and expectoration of mucus from the air-passages than usual, in the evening (first day), 1.
- Increased secretion of mucus from the larynx, in the afternoon and evening (second day), 5.
- Respiration.
- Noisy and agitated breathing, 37.
- Wheezing, rattling breathing, 50.
- The convulsive respiration at the outset had been soon succeeded by regular breathing, with snorting inspiration, and moaning expiration, 50.
- Gurgling noise in the throat, 46.
- Moaning noise (after five or ten minutes), 58.
- Uttering a low moaning noise, .
CHEST. [310.]
- Tension of the chest, aggravated by inspiration, especially affecting the lower portion of the thorax, in the region of the seventh and eighth ribs, transversely across the chest (soon), (first day), 4a.
- Constriction of the chest, 30.
- Constriction in the chest, obliging deep inspiration (fourth day), 4.
- Constriction of the chest, and sudden difficulty of breathing, 24.
- A feeling in the chest as though there were constriction transversely across it, without however amounting to real pain (after two hours), 1.
- Violent constriction of the diaphragm, with a sense of suffocation, 47.
- Tightness of the chest, 20 ; (first and second days), 4.
- Tightness of the chest, gradually extending into the right side of the chest and becoming a pain which extends over the whole chest and makes breathing difficult (third day), 4a.
- Pressure and tightness in the chest (first day), 1a.
- Pressive pain in the chest, 2a. [320.]
- Oppression of the chest, 9, 20.
- Great oppression of the chest and difficult respiration, 16.
- Very acute pains in the chest and a feeling of anxiety, which only disappeared several hours after inhaling the fumes, 18.
- Stitches in the chest, on deep breathing (first day), 4.
- Some transient stitches in the right side, in the region of the fifth and sixth ribs, near the sternum (after half an hour), 2.
- Front.
- Slight sticking beneath the lower end of the sternum (second day), 5.
- Sides.
- Pain in the left side of the chest, in the region of the heart, with dyspnœa (fourth day), 4.
- Pressure in the right side of the chest (second day), 4.
- Pressive pain in the right side of the chest between the fifth and sixth ribs, near the sternum, lasting a quarter of an hour, 2a.
- Pressive pain, which afterwards became sticking, in both sides of the chest, soon (second day), 1a. [330.]
- Sticking pain under the short ribs of the right side, .
HEART AND PULSE
- Præcordium.
- Anxiety in the præcordium, 23.
- Præcordial anxiety, alternating with slight vertigo, pain in the same locality, not increased by pressure, lasting six hours, 20.
- Transient stitches in the region of the heart (second day), 1a.
- Heart's Action.
- Palpitation of the heart (second day), 1a.
- Palpitation, with soft, full pulse, 8.
- Heart's action very weak (after eight or nine minutes), 51.*
- Heart's action irregular, pulse hardly to be felt, 60.
- Irregular beat of the heart , with slow depressed pulse, 8.* [340.]
- Beat of the heart and pulse variable, sometimes frequent, sometimes seldom and intermitting, also weak, 33.
- Pulse.
- Pulse rapid and weak, 9, 46.
- Pulse more rapid but smaller and unequal in force, a weak impulse alternating with a strong one (second day), 4a.
- Pulse small, less energetic, and more rapid than usual (fourth day), 4.
- Pulse slightly increased in rapidity, smaller and unequal, so that after every six or seven beats there were one or two stronger and longer waves of the artery (soon), 4a.
- Pulse very rapid, 66.
- Pulse small and quick (after five minutes), 61.
- Pulse became quicker and less distinct, and the action of the heart could scarcely be felt whilst lying on his back, 46.
- Very frequent pulse, 37.
- Pulse 100, very small, feeble, yet regular (after one hour), 59. [350.]
- Pulse between 70 and 80 (after fifteen or twenty minutes), 58.
- Pulse rose, from 58 to 78, and had not regained its usual rate for an hour and a half, 42.
- Pulse previous to the experiment 57; 77 (after ten minutes); 57 (after one hour), 20.
NECK AND BACK
- Veins of the neck and face were strongly congested, 65.
- Cramp in the back, 12.
- Sudden pain in the region of the right kidney, extending thence to the epigastric region, and then spreading over the whole abdomen, causing at the same time a feeling of increased warmth of the abdomen (third day), 4a.
EXTREMITIES IN GENERAL
- Extremities seemed bloodless, 44. [380.]
- Limbs quite flaccid (after a quarter of an hour), 43.
- The limbs were completely lax and fell lifeless when lifted, 44.
- Trembling of the limbs, 19.
- Trembling and uselessness of the limbs, 8.
- Legs, arms, and chest were slightly convulsed, the upper extremities more than the lower, 48.
- Some contractions of the extremities, but no tetanus, 60.
- After he had become insensible and while lying on the table, his thighs were drawn up on the abdomen, and rigid; the upper extremities were also observed to be rigid; and on drawing them from the side, they forcibly reverted to their former position; eyes shut; teeth clenched, and the muscles of the face violently convulsed (sixth day), 41.
- Movements difficult, as if from loss of power of the limbs, 35.
- Such weakness in the limbs and loss of power in the muscles that he thought he should have fallen, quite momentary (immediately), 68.
- Paralysis of the hands and feet (after three hours), 57. [390.]
- Limbs paralyzed and lay in whatever position they were placed; and they were free from all rigidity, 66.
- Extremities, although immovable and cold, had not however lost their sensibility, 57.
SUPERIOR EXTREMITIES
- Arms bent and the hands clenched (after eight or nine minutes), 51.
- The forearms became stiff and inflected on the arms, 46.
- Trembling of the right hand, 33.
- Hands partially contracted, fingers rigid, and about the nails of a dark-lead color, 48.
INFERIOR EXTREMITIES
- As soon as the legs were placed in a depending position they became very dark in color, from the bloodvessels being so congested, but immediately the legs were placed on the sofa after death, the appearance was lost, 48.
- Legs straight and stiff (after eight or nine minutes), 51.
- Unusual stiffness of the legs, 35.
GENERAL SYMPTOMS
- Objective.
- Increased secretions from the skin, glands, especially the salivary glands, kidneys, and serous membrane, 11. [400.]
- Muscular system in a state of rigidity (after eight or nine minutes), 51.
- Slight jerkings, 8.
- Spasms, 37.
- Spasm commencing in the toes, followed by distortion of the eyes, towards the right and upward, afterwards general spasm, distortion of the limbs, frightful distortion of the face, etc., 33.
- Trunk spasmodically bent forward, 50.
- A violent spasm, during which the body became rigid, the arms were twisted around, and more particularly the region of the stomach became distended (after one hour), 50.
- The body under such strong spasmodic action that the head seemed buried between the shoulders, and the arms nearly turned around by the action of the pronator muscles, 54.
- Convulsions, 12, 21.
- General convulsions (immediately), 40.
- Convulsions, with loss of consciousness, 35. [410.]
- Violently convulsed; the muscles of her face undergoing great distortion, her limbs becoming spasmodically extended, and her head drawn down on her shoulders, 49.
- Convulsions became stronger; he drew himself up in his seat, supported behind by the right arm, contracted the inferior extremities, and with a fierce look and fixed eye, uttered three hideous groans, then twisted the body towards the left side, with the face to the floor (after three hours and a half), 46.
- Tetanus, 21.
- Violent tetanic convulsions, lasting several hours (after one hour), 32.
- At first convulsions, afterwards paralysis, 21.
- Body excessively relaxed, and without any convulsive movement (after one hour), 59.
- Muscles relaxed and flaccid, with the exception of the muscles of the jaw, the jaw being firmly closed (after five minutes), 65.
- The patient rose up slowly and unsteadily, 33.
- Aversion to mental or physical exertion, 9.
- All motion, especially walking, was difficult and caused perspiration (second day), . [420.]
SKIN
- Objective.
- Great paleness of the whole surface, which was also extremely cold to touch, 62.
- Rubescence appeared on the arms in twenty minutes, and on the legs in forty, 46.
- The integuments about the neck and breast became livid and of a yellowish tinge, 46.
- Subjective.
- Formication, especially at the epigastric region, 35.
- Prickling in various parts of the body, 35.
- Formication of the limbs, 35.
- Some creeping in the skin of the thighs (fourth day), 3a.
- Itching on the neck and arms, 35.
SLEEP
- Yawning, 9. [480.]
- Could not resist frequent yawning, with overpowering desire to sleep; and contrary to his habit he slept soundly for some hours; on waking from this sleep he was very much confused in his head, and it was scarcely possible to keep awake (third day), 3.
- Sleepiness (from the smallest dose), 10 ; (third day), 4 ; towards noon (third day), 4a.
- Overpowering sleepiness, 9.
- Slumber, 11.
- Sleep prolonged and deep, 35.
- Sleeplessness, 35.
FEVER
- Chilliness.
- Coldness of the skin (after fifteen or twenty minutes), 58.
- Skin cold and clammy, 67.
- Chilliness, 19 ; (after a quarter of an hour), 46.
- Very chilly, is very cold to the touch, 6. [490.]
- Frequent creeping chills from time to time, in the afternoon (second day), 5.
- Violent chill alternating with heat, with stupefaction and vertigo (after a quarter of an hour); the sensation of heat lasted about twelve hours, 16.
- Febrile chill over the whole body followed by general warmth, 35.
- Feeling of coldness, 35.
- Frequent attacks of coldness, shivering (third day), 4a.
- Slight shivering, as from febrile paroxysms, coming on in the afternoon while riding in a wagon over a rough road (third day), 5.
- Shuddering like electric shocks, 35.
- Rigors which disappeared after swallowing coffee and brandy (after four hours), 46.
- Cold extremities, 12, 32, 34, 36 , etc.
- Heat.
- Inclination to heat and sweat (second day), 1a. [500.]
- Warmth, especially of the feet, 35.
- Sweat.
- Increased perspiration, 35.
- Body covered with sweat, 37.
- Body covered with clammy sweat, 34.
- Cold clammy sweat over the surface (after a quarter of an hour), 43.
- The perspiration caused by the acid was momentary, not lasting over five minutes, 35.
- Skin dry, 6.
- Face covered with cold perspiration, 46.
CONDITIONS
- Aggravation.
- ( Afternoon ), Chills.
- ( Evening ), Pressure, etc., in head; cough; mucus from air passages; weakness.
- ( Night ), Headache.
- ( After eating ), Heartburn.
- Amelioration.
- ( Open air ), Pressure, etc., in the head.
- ( Coffee ), Hiccough.
- ( After eating ), General relief.
SUPPLEMENT: HYDROCYANIC ACID. Authorities.
69 , Manchester Examiner (Pharm. Journ., Second Ser., vol. vii, 1866, p. 487), Catharine Joyce committed suicide with an overdose; 70 , John W. Tripe, Brit. Med. Journ., Jan., 1877, p. 11, D. A. took Scheele's acid, death in eight or nine minutes; about 2 minims were found in his stomach; 71 , Dr. Hunt, Med. Times and Gaz., 1878 (1), p. 37, a boy, æt. three years, ate several bitter almonds; 72 , E. W. Berridge, Am. Obs., 1876, p. 15-16 (Hom. Times, vol. vii, p. 12, of Retrospect of Literature), a girl took 1 grain.
- Staggering, and soon fell to the ground; groaning; breathed quick; foaming at the mouth; hand clenched, 69.
- Eyes prominent and glistening; pupils slightly dilated and insensible to light; lips, as well as the tongue, purplish; gasping for breath with his mouth wide open; heart's action had ceased, whilst the breathing was irregular and gasping, and continued so for about two minutes, when he ceased to live; pulse scarcely perceptible; muscles of the arms relaxed; fingers contracted; skin clammy; a very small quantity of vomit on his beard and clothes, 70. [510.]
- Apparently unconscious, slightly cyanotic, and markedly pale, with eyelids closed; on raising the eyelids the pupils were seen to be moderately dilated; the arms were stiffened through tonic spasms of the muscles, 71.
- She instantly jumped up, ran for a short distance, holding up her arms and gasping for breath, fell and became insensible, and was violently convulsed; muscles of the face undergoing great distortion, limbs spasmodically extended, and head drawn down upon the shoulders; she was then removed to a bed; whole body was drawn a little forward; the limbs fixed and extended in tetanic spasm; face swollen, turgid, and almost purple from congestion; jaws clenched, mouth covered with foam, eyes half closed, prominent, and glistening; pupils widely dilated, insensible to light; breathing slow, with deep prolonged inspiration, and uttering a low moaning and could not bear light; an hour and a half before death was insensible, face pale and cold, pupils contracted, respiration slow and stertorous, pulse quick and weak, 72.