STRAMONIUM-DATURA STRAMONIUM [Stram]:

- M.L.Tyler.

Thorn-Apple.

Introduction:
HAHNEMANN says: This narcotic plant shows in its primary action (with the exception of disagreeable sensations, which the prover cannot call "pain"), no actual pains. Sensations which can strictly be called pain occur only in the secondary action, i.e. the subsequent reaction of the organism. This restores not only normal sensation as opposed to the sensation destroying action of the drug, but when given in large doses, causes morbidly exalted sensation, or pain. Again: in its primary action it produces great mobility of voluntary muscles and suppression of all secretions and excretions; the reverse of which occurs in the secondary action- to wit, paralysis of muscles, and excessive secretions and excretions. Therefore, in suitable doses it curatively allays spasmodic muscular movements and restores suppressed excretions in several cases in which absence of pain is a prominent symptom. It can only cure homoeopathically the morbid states produced by its primary characteristic action. The symptoms of the secondary action (which, as with all narcotic drugs, are much more numerous, better expressed, and more distinct than with non-narcotic drugs), teach the observant physician to refrain from its employment in cases where the patient is already suffering from ailments resembling those of its secondary action. He would never administer Stram. in complete paralysis, or where violent pains constitute the chief feature of the disease. He speaks "from experience" of the incomparable curative action of Stram. "in similar natural mental maladies" and of its usefulness in convulsive ailments similar to those it causes. . . Its efficacy also in some epidemic fevers, with the symptoms it can excite in mind and body:-in varieties of hydrophobia, from the bite of rabid animals, which cannot all be cured with one remedy, but some of which require Belladonna, some Hyoscyamus, and yet others Stramonium, according as their morbid symptoms are more similar to one or other of these three plants. HUGHES (Pharmacodynamics): "Stramonium is as Hahnemann points out, exquisitely homoeopathic to hydrophobia, even more so than Belladonna. He says that in China, the different species of Datura, among them the D. Stramonium, are in popular use as prophylactics against hydrophobia. It is said that enough of the plant should be taken to provoke an attack of `rage', the patient is then safe." He says there are few neuroses in which Stram. is not more or less useful. It is our chief remedy in acute mania, to which it is more homoeopathic than the more inflammatory Belladonna. It is hardly less valuable in delirium tremens, in the active form- the mania-a-potu of the older writers. The constant association of hallucinations with its delirium, make it very appropriate here. In nymphomania and puerperal mania it stands highest among remedies, owing to its special action on the sexual functions. Epilepsy, brought on by a fright. In chorea, one of the best vegetable medicines. He quotes Guernsey, in regard to the following indication: "Parturient women show such signs of fear as to cause them to look frightened and to shrink back from the first objects they see after opening their eyes. If they have had no spasms, they soon will have, after betraying such symptoms, unless Stramonium be immediately administered. His other indications are: Great loquacity, expressing wild and absurd fancies; desire for light and society; an imploring, beseeching mood." ALLEN'S Encyclopedia gives six and a quarter pages of references for the 243 different poisonings and provings, whose symptoms are more or less set forth in the 1, 680 given. The majority are poisonings by the drug, but there are provings, even in high potency. Glancing down the black letter symptoms only, apart from the important symptoms in italics, one sees hydrophobia, mania, violent delirium and delirium tremens, epilepsy, chorea, with a high degree of hallucination, and FEAR. It is not the vague fear of Aconite, but something more concrete-fear of objects seen in imagination: seen more at the side than in front, curiously. Stramonium has much that is in common with its cousins, Belladonna, and Hyoscyamus: and comes up for consideration for many of the maladies that both mirror forth. But Stramonium seems to lack the inflammatory intensity of Belladonna. HALE WHITE, who supplies the teaching in Materia Medica for medical students, describes in twenty-one short lines the ACTION AND THERAPEUTICS of Stramonium. He says its action is almost the same as Belladonna, and that there is no reason why Stramonium should not be applied for the same purposes as Belladonna. And the only use he has for this 50 powerful and valuable drug, is that of a palliative to relax the muscular coat of the bronchial tubes-more powerfully than Belladonna. He describes a powder, which, burnt, gives off dense fumes, and affords great relief in asthma; and he adds that "Himrod's Bliss's and other `cures' for asthma, are of similar composition". He wisely puts cures in inverted commas, because palliatives do not cure; they relieve protem.; and as we know, such powders may have to be burnt again and again in one night. And yet Stramonium should cure some cases of asthma, because it has caused difficult breathing: especially in connection with spasm of diaphragm. CULPEPPER (Herbal, 1653) mentions Stramonium for epileptic disorders, convulsions and madness:-its ancient reputation, as we see, amply confirmed from the homoeopathic standpoint by poisonings, provings and practice. To get an-all-round knowledge of the uses of any drug, one has to get the impressions of many prescribers and their experience in regard to its usefulness. BOGER (Synoptic Key) stresses: "A REMEDY OF TERRORS, BUT LACKING IN PAIN. Disorderly, graceful, or rhythmic movements. DREADS DARKNESS, and has a horror of glistening objects. Great thirst, but dreads water. Putrid, dark, painless involuntary diarrhoea. Awakes in fear, or screaming." GUERNSEY (Key notes), who has a talent for going straight at the main features of a drug, says, of Stramonium: "The principal range of this remedy is found in the mental affections. In young people, sometimes hysterical, praying, singing devoutly, beseeching, entreating, etc. (Young women with suppressed menses may be thus affected.) In fevers where the patient cannot bear solitude or darkness; if they are left alone in a dark room, the mental affections are very much aggravated. Also in unconscious delirium when the patient will now and then jerk the head up from the pillow, and then let it fall-this being kept up without intermission for a long time. women in puerperal fever may have absurd notions-that they are double, that someone is in bed with them, and other strange unmeaning fancies. Affections of the intellect; madness. `"Face red and bloated Cannot walk, or keep on the feet in a darkened room, falls." NASH sums up Stramonium thus: "Wildly delirious with red face and great LOQUACITY. "Pupils widely dilated; wants light and company; fears to be alone. Wants hand held. (Zinc.) "One side paralysed, the other convulsed. "Wakes with a shrinking look: frightened afraid of the first objects seen. "Painlessness with most complaints (Opium). Jerks the head suddenly from pillow in spasms." He calls it one of the trio of pre-eminently high-grade delirium remedies, differing from the other two chiefly in the degree of intensity. He says: "The raving is something awful. Singing, laughing, grinning, whistling, screaming, praying piteously or sweating hideously, and above all remedies loquacious." Again the patient throws himself into all shapes corresponding to his changeable delirium, crosswise, lengthwise, rolled up like a ball, or stiffened out by turns. . . Things look crooked or oblique to him. Mouth as if raw: tongue stiff as if paralysed. Stools loose, blackish, smelling like carrion, or no stool or urine. Later, loss of sight, hearing, speech with dilated, immovable pupils and drenching sweat that brings no relief. Death must soon close the scene, unless Stram. helps them out. He contrasts the three: Stram is the most loquacious. Hyos, is the most insensibly stupid. Bell. stands half-way between. Stram. throws himself about, jerks head. Hyos. twitches, picks and reaches, otherwise lies pretty still. Bell. starts or jumps, falling or awaking from sleep. All have times of wanting to escape. . . Now for some of KENT'S special points:-When considering Stramonium, the idea of violence comes into mind one wonders seeing a patient poisoned by, or needing Stramonium, at the tremendous turmoil, the great upheaval taking place. Excitement., rage, everything tumultuous, violent: face wild, anxious, fearful; eyes fixed on a certain object: face flushed: hot, raging fever with hot head and cold extremities. Turns from the light: wants it dark: aggravated especially by bright light. High fever with violent delirium: heat so intense it may be mistaken for Belladonna: but usually a continuous fever, while the intense fever of Bell. is remittent always. Like an earthquake in violence. Mind in an uproar, cursing, tearing the clothes, violent speech, frenzy, erotomania, exposing the persons. (Useful in violent typhoids.) Mania that has existed for sometime. A single attack would look like Bell. But Bell. might be a palliative in the first attack, and in the second would do nothing. When the delirium is not on, patient has the appearance of great suffering: forehead wrinkled: face pallid sickly, haggard. Anxious look, indicative of intense suffering from meningeal involvement. Delirium, bland, murmuring, incoherent chattering with open eyes; vivid; merry, with spasmodic laughter; furious, raving wild: attempts to stab and bite; with queerest notions fear as if a dog were attacking him. Strange ideas about the body, that it is ill-shapen, elongated, deformed. Sees animals, ghosts, angels, departed spirits, devils: knows they are not real, but later is confident they are. Sings amorous songs and utters obscene speech. Screams till hoarse and loses voice. Screeches and screams day and night with fever, or mania. Hyos. has wild maniacal delirium, but very little fever. In Stram. there is considerable fever. In Bell. the fever is afternoon and evening (3 p.m. to 3 a.m.)., and then a remission. Puerperal convulsions and insanity. It has the septic nature. "Has sinned away her day of grace, "Yet has lived an upright life. Cerebral congestions; profound intoxication: stupor: stertorous breathing: lower jaw dropped. Typhoid, with oozing blood from mouth, tongue dry swollen, fills mouth, pointed, red like a piece of meat. Basilar meningitis from suppressed ear discharge. Forehead wrinkled, eyes glassy awful pain through base of skull with a history of necrosis about the ear. Violent headache from walking in the sun: worse lying down. Worse motion and jar. Pain in occiput. High grade inflammation-pus forms, abscesses with excruciating pain vicious septic states. Chronic abscesses:- the left hip-joint is a special locality. Stram. stands alone among the deep-acting remedies, in its violence of mental sufferings. Suppuration of lungs where cough is worse from looking into the light. Delusions in regard to personal identity. Great anxiety when a train is going through a tunnel.
BLACK LETTER SYMPTOMS
Maniacal delirium: symptoms resembling HYDROPHOBIA. Delirium of fear, as though a dog were attacking him. Impressions of danger: clings to persons who had him in her lap. Noisy DELIRIUM with HALLUCINATIONS. Appearance of patient suggested mania. "There are those bugs, help me catch them." "There, a long trail of bedbugs, and after them a procession of beetles, and here come crawling over me a host of Cockroaches." He shrank back in alarm: then suddenly, 'I believe I know they are not really bugs: but except once in a while, they seem real to me." (Biting a man's hand), sometimes crying out that she saw cats, dogs and rabbits, at the top, sides and middle of the room. (Speaking) the sound resembled a squeak more than the natural tone of the voice. Manifested great aversion to fluids of every kind. When a cup of water was put to her lips, she would start from it, and sometimes relapse into her paroxysm: such great aversion to it, that it was with the utmost difficulty that any liquid could be forced down her throat. Hydrophobia: Aversion-even rage, when it was attempted to administer any liquid. Had even spasmodic irritation of pharyngeal muscles, and anything taken choked him and was regurgitated. Asked her mother not to leave her, "something was going to hurt her." Constant staring about, then a fixed gaze, with sudden startings of arms, and lower limbs, with low mutterings, then sudden and furious screaming, scratching , tearing with the hands, and kicking. He makes all motions hastily. From the expression of face and movements, he seem at times to be chasing, or fleeing from imaginary objects. Terrified by fanciful delusions: they appear to grow out of the ground at his side-large dogs, cats and horrible beasts, from which he springs away with signs of terror, but cannot get away from them. Continually strange objects intrude on his fancy, frightening him. He sees more horrifying images at his side than in front of him. The boy seemed to see black objects. (An executioner standing before him seemed to him a reality. All ideas seemed to consist of mere reproductions: there was nothing original, no new combinations. Occupied with hallucinations: gaze fixed; seemed trying to reach towards something she saw. Solely occupied with objects of his fancy. The sight of a light, a mirror, or water, excited horrible convulsions. Quite irrational: picked the bedclothes, saw bugs, etc. Shuddering and seeming much frightened. Starts up in affright. FEAR of being in the dark, and (less) of being alone in the evening after sunset. Conduct and countenance like that of a child severely frightened, and apprehending some terrible calamity. DELIRIUM: bland: murmuring: violent: foolish: joyful: loquacious: incoherent: chattering: with open eyes: vivid: merry: with spasmodic laughter: furious: raving: wild attempts to stab and bite: with queerest notions: with sexual excitement: fear as if a dog were attacking him: conscious of her condition: calls for papa and mama, who are present and trying to console child: with open eyes: noisy with hallucinations; shy, hides himself: tries to escape: full of fear: talks incessantly, absurdly, laughs, claps hands over head wide open eyes. Mania for light and company: cannot bear to be alone. DELIRIUM TREMENS. Hallucinations which, especially at night, put patient into wildest restlessness. Laughing. Intoxication. Rush of blood to head. Violent congestion of head. EYES wide open, prominent: pupils exceedingly dilated, insensible, with injected conjunctivae, as if vessels filled with dirty liquid. Complained that it was dark and called for light. Hallucinations DARK. (Bell., fiery, shining.) Hot cheeks. Blood rushing to FACE White circle round mouth. Wild staring look: expression of great fear and terror. (Acon). Glairy saliva dribbling from MOUTH. Speech stammering, difficult and unintelligible. Has to exert himself a long time before he can utter a word. (Distorts face, makes efforts to speak.) Dryness of THROAT: Constriction. Spasmodic constriction of throat, a kind of paralysis, so that swallowing was very difficult -almost impossible. Fauces dry: very red: with difficult swallowing. Terrible spasm of throat on each attempt to swallow, like hydrophobia. Dryness of throat not removed by frequent draughts of water. The child had not only lost power of utterance, but that of voice. Could only utter a hoarse croaking sound, alternating with sonorous croupy barking cough: unable to swallow for the violent spasms. Thirst violent, for sour drinks. Fear of water: and aversion to all fluids. ABDOMEN distended, not hard. Stool and urine suppressed. VOICE hoarse and croaking. High, squeaking, out of tune. Usual modulation quite lost: higher and finer than usual. Twitching of hands and feet; of tendons; of extremities: during chill: through body like CHOREA. Trembling of limbs. Trembling of whole body, seemed as if in a great fright. CONVULSIONS. Frightful convulsions at sight of a lighted candle, a mirror, or of water. Now rejected every liquid, and seemed to labour under hydrophobia, for the moment a cupful of drink touched lips, the spasms returned with great violence. Child became restless: tossed about: called for water: could swallow with great difficulty. Constant restless movements of all limbs and the whole body. Convulsions, alternating with rage: opisthotonic, from bright, dazzling objects, a lighted candle, a mirror, or touch. Child rigid as a board, when loudly spoken to or when touched. Shrieks in hoarse voice. Scarlatinous redness of SKIN. Intensely red rash in skin,. resembling scarlet fever, but having a more shiny appearance. Scarlet efflorescence over the whole body. HEAD very hot. Skin hot, dry, burning: scarlet. Child will not go to SLEEP in the dark, but soon falls asleep in a lighted room.
STRANGE, RARE AND PECULIAR SYMPTOMS.
Hands and arms in motion, as if spinning or weaving. Grasps about in air, catching at imaginary objects. Motionless, pulseless: then tossed about in great rage: made signs to those about him, not understood. Condition resembles highest state of intoxication from alcohol. Calls things by wrong names, his boots, logs of wood; his bedroom, the stable. No correct estimate of distance or size: reaches for things across the room: bumps into persons and things which appear to be distant. Uses wrong words, cannot find right words. Talks in different languages. Sits silent, eyes on ground, picking at her clothes. Mind wanders, with quick motions of eyes and hands. Excessive dilatation of pupils, with slow pulse. Aberrations of mind. One carries home wood to manufacture. brandy: another places two axes across each other to split wood: a third burrows in ground like a pig with his mouth: a fourth was "a wheelwright", and began to bore holes: a fifth ran into forge, to catch fish which he saw swimming there a girl ran about the room and cried that all evil spirits were pursuing her. Face expresses perturbation-stupidity-FEAR. Converse with spirits: is under influence of spirits; has communications from God; delivers sermons: prophecies. Animals jump out of the ground sideways: he moves quickly to other side, where others start up and pursue him. Thinks he is tall: double: lying crosswise: that he was killed, roasted, and being eaten. Sees more horrifying images at his side, than in front of him: they all occasion terror. Seemed to see black objects: spoke of black people and black clouds: grasped at air. Rush of blood to head with furious loquacious delirium. "A dog is biting him and tearing flesh off his chest"; complains of violent headache: confessing and praying: wants to be killed : to be kissed: accuses his wife of unfaithfulness: will not be touched; takes people for dogs and barks at them. Is a distinguished person. Threatens to use knife on those about him: to break furniture: to throw himself out of the window. Thinks he has snakes in him: lizards: worms in his clothes. Religious mania: pious looks: praying: inspired talking: despair of her salvation. Water, or a mirror, or anything bright excites convulsions. Screams and howls. Wants to kill people, or himself . Changeable anticipation of death, and rage' then laughable gestures: then haughtiness and inconsolableness. Obscene thoughts and actions. Sought to bite, or to catch flies. Sings and utters obscene things. Laughing. Makes faces: imitates motions, gestures and voices of different animals. Suicidal: wants a razor to cut his throat. Pangs of conscience: thinks he is not honest. On being reprimanded, pupils dilate immediately. Child very cross; strikes or bites. Going down stairs takes two steps for one, and falls. Alae nasi white, face red. Taste bitter: all food bitter; all taste lost. Tongue whitish with fine red dots! In constant motion: swollen; hangs out of mouth. Averse to fluids: to water, even the sight of it causes spasms. Violent desire to bite and tear things with his teeth. Sight of a light, mirror, or water excites horrible convulsions. Froths at mouth and constant spitting. Violent thirst with desire for sour drinks. Great desire for acids. Better for vinegar. Very violent hiccough. Flow of very salt saliva. Vomits water, bile, dark-green substance: green bile. As if navel were to be torn out. Wind in abdomen wakens her: screams, thinking herself full of creeping things. As if urine could not be passed, for narrowness of urethra. As if cylindrical body were being pushed through urethra: better after drinking vinegar. Sexual irritation: hands constantly on genitals. Nymphomania. Metrorrhagia with excessive loquacity, singing, prayers, praise. Shrinking look, when awaking. Aphonia: aphasia: stammering. Excessive sense of suffocation. Hard pressure on cartilages of third and fourth ribs with difficult breathing: unable to inhale enough to breathe without anxiety. When coughing while sitting, lower extremities are jerked up. Something turns round in chest. Diaphragmitis. As soon as she falls into a doze, profuse sweat breaks out (Con.) Arms thrown about: thrown upwards. Beating with one arm, grasping with the other. Falls over his own feet. Fingers and heels numb. Falls with full consciousness, bent backward so that heels touch. occiput; suddenly snaps forward again. Falls in the dark: can walk well in light. Voluntary muscles do not obey will. Continual cramp in hands and feet. Great movability of limbs. Strange involuntary motions. great agility. Sensation in joints as if all parts of limbs were completely separated from each other. Arms and legs separated from body: hands and feet loosened in joints. (And so on convulsions: chorea: hysteria: epilepsy: etc.) Awakes: does not know where he is: with a solemn air of importance; screaming, frightened, knows no one, shrinks away or jumps out of bed; with staring eyes at one point: assumes a comically majestic appearance. As if cold water poured down back. As if sparks of fire rushing from stomach to eyes. It is important to recognize the exactly opposite conditions produced (and curable) by Stramonium. Cursing and praying (as the boy who gets hauled to his feet in passages and odd corners, where he has fallen to his knees in prayer-one remembers such a case). Desire for light, unable to walk, or to sleep in the dark (like the young man who has to have a night light because he "screams the house down" if it goes out) and yet convulsions renewed by the sight of bright objects. Again, the violent convulsions, with horrible distortions of the face; or only the (characteristic) "disorderly graceful, rhythmical movements in delirium or chorea, utterly unlike the angular jerkings of Hyos." ( All remembered cases.) One recalls several striking instances of the rapid curative action of Stramonium. Two cases, scribbled into the margin of Allen's Encyclopedia, at the time, come up opportunely. (I) A big strong Scotchman, years ago, when influenza, after many years absence, came back to mightily stampede the doctors, and to claim a large number of victims including one of the princes, went down with a bad attack of the prevailing epidemic. He had a very high temperature, frightful pain, "right in the hair of my heed", as he afterward expressed it; with delirium, and vomiting of green matter. But the "strange, rare and peculiar" symptom here was, that he said that the glass of water his wife brought him was black,. and that her face was black. This black vision suggested Stram. and he was cured in a few hours by Stram. 30. (No.2), long forgotten but scribbled in below, at the same time, reads: "Alice" (a housemaid). "Bad pain all day across head, but right inside it, cured by one dose of Stram. A third a more recent Hospital case, already given, must be retold here where it belongs. It was an amazing case. . . . . A woman of 33 was brought into L.H.H. on January 17th, 1930. The old school doctor who sent her in had been treating her for the last 14 days for pyelitis and frequent heart attacks, with a temperature of 104:-and the previous year for "mitral incompetence and albuminuria." On admission there was much pus and blood in urine; some lumbar pain, and difficulty in urination. She appeared to be very ill; but on admission there was nothing abnormal found in the lungs. Next day, she was restless and delirious towards evening, with morbid fears, and a temperature of 104.8, respiration 24. On the third day temperature 104-104.8, respiration now 44. She had developed a very rapid double pneumonia. Skin flushed, hot dry. Delirium. Thirst. And at night restlessness with twitchings of face and hands. Temperature 104. Respiration 34-48 (in spite of Phos.30, which she had been having at six-hourly intervals). And she had only passed II oz. of urine in twenty-four hours. On the fourth day, pretty twitchings of face: hands twitched:-a peculiar "angelic" smile in delirium. She was conscious when roused. It was observed that the temperature was always at its highest at NOON (" as now 104.6") The case was reconsidered having regard to its unusual and characteristic symptoms. For fever at noon, there is only one drug in italics.-Stram. The graceful spasms and twitching of face-"facial muscles constantly play in delirium"-again Stram. Then the character of the delirium, lacking the violence of Bell. together with the fever, the dry hot skin, and the suppressed urine, again suggested Stram. So at noon on the fourth day of admission- the second day of the pneumonia, she was given Stram., 1M., three doses, four-hourly. The results was dramatic! viz., a quieter night; no twitching; no delirium. Quite sensible. Temperature coming down Next day it rose once more, but at 8 p.m., not noon, and only to 103.8-a degree lower; when she got three more doses of Stram. 10 M., After which, with one more small rise it dropped,-to remain sub- normal for some days. A day later, as she was weak and drowsy, and "looked toxic " she was given three doses of Arnica 200; after which she needed no more medicine. Stram. was given on the second day of the double pneumonia and she was sub-normal three days later. By February 18th she was walking about the ward; and was discharged a fortnight later, "Lungs normal, heart normal, urine normal. Quite well." The interest in this case was its great severity (the doctor who sent her in believed her to be dying of pyelitis and heart trouble before the double pneumonia supervened), and the unusual drug for pyelitis and double pneumonia. This case shows the curative remedy was found on a very few, but characteristic symptoms not of pneumonia, or pyelitis, but of that individual patient exhibiting those disease those disease-conditions. Here Hahnemann's "totality of Characteristic Symptoms." suggested a remedy to which the patient undoubtedly owed her life. And with this we may quit Stramonium. A marvellous drug. rightly applied-they all are!-yet only worthy of twenty-one short lines in Hale White's Materia Medica, the text book for students of medicine. Things are moving at last: and one wonders how long it will be before medical students are allowed to take their course of Materia Medica with us! We have no desire to run a medical school: all the rest can better taught elsewhere, with appliances and first-class teachers: but-Materia Medica! Good Lord! NO wonder so many doctors have "lost their faith in medicine." * * * * * NASH gives a case of acute mania, cured with Stramonium,. "A lady about 30, overheated in the sun, on an excursion. A member of a Presbyterian church, but she imagined herself lost, and called me in six mornings in succession to see her die. Lost , lost, lost, eternally lost, was her theme, begging minister, doctor, everybody, to pray for and with her. Talked day and night about it. I had to shut her up in her room alone for she would not sleep a wink or let anyone else. "She imagined her head was as big as a bushel, and had me examine her legs, which she insisted were as large as a church. After treating her for several weeks with Glon., Lach., Nat. carb. and other remedies on the cause as the basis of the prescription, without the least amelioration of her condition, I gave her Stramonium, which covered her symptoms, and in twenty- four hours every vestige of that mania was gone. She was to have been sent to the Utica Asylum." (Nash gave her the sixth potency.).

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