GELSEMIUM [Gels]:

- A.W. Cowperthwaite.

Synonym. Gelsemium Sempervirens. Natural order. Loganiaceae.

GENERAL ANALYSIS.
Acts powerfully upon the motor nervous system, causing a passive congestion of the brain and spinal cord, and as a result giving rise to convulsions and general prostration and paralysis of the whole muscular system, both voluntary and involuntary,finally paralyzing respiration. The circulation is increased, the mental powers becomes sluggish, the mucous membranes are irritated and inflamed, and conditions resembling remittent and catarrhal types of fever are manifest. The leading expression of Gelsemium is its low nervous condition, manifested by drowsiness, languor, disposition to be quiet, and erethism.
CHARACTERISTIC SYMPTOMS.
Mind. Incapacity to think or fix the attention (AEthus., Cimic., Nux v., Phos. ac.). Dullness of the mental faculties, (Ailanth., Bapt.); better from profuse micturition. Irritable, sensitive; desire to be let alone (Coloc). Unconsciousness. Delirium in sleep; half walking, with incoherent talk. Cataleptic inmobility, with dilated pupils, closed eyes, but conscious. Head. Dizziness and blurred vision. Light-headed and dizzy; increased by sudden movement of the head, and walking. Heaviness of the head; relieved after profuse emission of watery urine. Sensation of weight and pressure in the head. Fullness in the head, with heat in the face and chilliness. Brain feels as if bruised (Hell., Nux v.). Dull dragging pain in occiput, mastoid and upper cervical region, extending to shoulders. Pain in occiput at night, occasionally extending into frontal region. Sensation of a band around the head above the ears (Ant. tart., Carb. ac., Chel., Coca.,Merc., Nitr. ac.). Fullness in head; heat of face; chilliness; pulsation of the carotids; thick speech; brain feels bruised; eyeballs sore when moving them (Bry., Cimic.). Pressure on vertex so great as to extend into shoulders; head feels very heavy. Eyes. Drooping of the eyelids (Caust., Zinc.); they are heavy; can hardly open them or keep them open (Coni., Natr. carb., Naja., Natr. ars.). Dilated pupils (Bell., Hyos., Op., Stram.). Dimness of sight and vertigo. Smoky appearance before the eyes (Cycl., Phos.), with pain above them. Confusion of sight; blindness; astigmatism. Sees double when inclining the head toward the shoulder; controlled buy effort of will. Eyeballs oscillate laterally when using them. Ears. Sudden transient loss of hearing; rushing and roaring in the ears (Coccul., Cham., Led.). Catarrhal deafness, with pain from throat into middle ear. Nose. Irritation of the nasal passages; sneezing; tingling; coryza; (Acon., Merc. cor., Sang.). Fullness at root of nose, pains extend to neck and clavicles. Face. Heavy, besotted expression (Bapt.); flushed and hot to the touch (Bapt., Bell., Op.). Sensation of stiffness in the muscles of the face. Mouth. Tongue thickly coated; yellowish-white. Numbness of the tongue; feels so thick he can hardly speak; partial paralysis (Caust., Coni., Hyos.). Lips dry, coated with dark mucus. Mouth dry. Throat. Dysphagia; paralysis of the organs of deglutition; swallowing causes shooting into the ear. Spasmodic sensation and cramp-like pains in gullet. Painful sensation of a lump in the oesophagus. Diphtheria; local tingling of the parts during the fever; incipient paralysis. Stomach. Feeling of emptiness and weakness in the stomach and bowels (Hydras., Sep., Sulph.). Oppression and fullness in stomach; worse from pressure of clothing. Abdomen. Sudden spasmodic pain in upper part of abdomen; leaving a sensation of contraction, and causing him to cry out. Acute catarrhal enteritis during damp weather. Tenderness in right iliac region during typhus. Sensation of soreness of the abdominal walls. Stool. Diarrhoea after sudden emotions, grief, fright, bad news (Ign., Phos. ac., Op.); anticipation of any unusual ordeal. Urging to stool caused by exciting news, stool papescent, dark yellow. Stools yellow; faecal; bilious cream-colored; clay-colored; green. Urinary Organs. Copious discharge of clear, limpid urine (Phos. ac.), relieving the headache. Incontinence from paralysis of the sphincter (Caust.); nervous children. Feeling as if something remained behind when urinating, stream intermittent. Tenesmus of the bladder (Canth., Caps., Merc. cor.). Male Organs. Involuntary emissions of semen without an erection (Cinch., Phos. ac.); also during stool. Female Organs. Severe, sharp, labor-like pains in uterine region, extending to back and hips (Cimic., Sec. c.). Spasmodic or neuralgic dysmenorrhoea (Cimic.). Cramps in the abdomen and legs during pregnancy; diplopia; drowsiness (Nux m.); loss of muscular power; convulsions (Bell., Hyos.). Inefficient labor-pains or none at all; os widely dilated; complete atony (Caul.). False labor- pains; rigid os (Bell., Cimic.). Heart and Pulse. Irregular beating of the heart; palpitation. Feeling as if the heart would stop beating if she did not move about., Pulse frequent, soft, weak, almost imperceptible (Acon.); slow, but arterial tension increased. Neck and Back. Myalgic pains in the neck, mostly in upper part of the sterno- cleido muscles, back of the parotid glands (Acon.). Pains from the spine to the head and shoulders. Congestion of spine; prostration; languor; muscles feel bruised, and do not obey the will. Locomotor ataxia; paraplegia. Dull aching in lumbar and sacral regions; cannot walk; muscles will not obey. Limbs. Trembling in all the limbs (Coccul., Coni.). Deep seated, dull aching in the muscles of the limbs and in the joints. Gradual loss of control. Neuralgic and rheumatic pains in the extremities (Bry., Cimic., Rhus tox.). Lower Limbs. Fatigue of the lower limbs after slight exercise. Loss of muscular power in the legs; they will not obey the will; staggering. Generalities. Excessive irritability of mind and body. Trembling and weakness; listless and languid; easily fatigued (Ferr.), especially in lower limbs. Complete relaxation and prostration of the whole muscular system with entire motor paralysis. Takes cold at the slightest change of weather. Neuralgia; acute, sudden, darting pains, shooting, tearing along the track of nerves; especially if aggravated by changes in the weather. Congestions, arterial or venous, with sluggish circulation. Sleep. Restless sleep, worse towards morning; unpleasant dreams, after midnight. Sleeplessness from nervous irritation (Bell., Coff.). Languid and drowsy, but cannot compose the mind for sleep. Fever. Chilliness, languid aching in back and limbs, sense of fatigue, every afternoon 4 to 5 o'clock. Chills begin in the hands; chills running up the back, hands and feet cold. Febrile chilliness; cold extremities; heat of the head and face. Fever heat, with drowsiness; languid, wants to lie still. Aggravation. From any movement or touch; from fluids, of which there is great dread. Conditions. In nervous persons; young people; children. Compare. Acon., Arg. nit., Bapt., Bell., Bry., Caust., Cimic., Coni., Cinch., Nux v., Op., Rhus tox., Stram., Verat. vir. Antidotes. Cinch., Coff., Salt.
THERAPEUTICS.
Gelsemium is one of the most valuable of our fever remedies, occupying a sphere distinctly its own, the indications for its use being plain and unmistakable. It may be indicted in the first stage of many forms of fever, catarrhal, eruptive, bilious, remittent, etc. (rarely inflammatory). In such cases it must be differentiated from Aconite by the absence of great restlessness; from Belladonna by the less violence, less cerebral congestion, flushed face, etc.; the Gels, patient, though nervous and irritable, being languid and listless and wishing to be let alone, with frequent but soft pulse, prostration, vertigo, and usually more or less languid aching in the back and limbs. Thus in Gels. fevers there is an asthenic tendency. It is often a valuable remedy in first stage of typhoid fever, and may be useful at any time in the course of the disease when so-called nervous symptoms predominate. It is especially valuable in malarial fevers, especially in those of recent origin, where the system is not thoroughly impressed by the poison; either remittent or intermittent; generally the rise in fever occurs toward evening with drowsiness, languor, dizziness, blindness, prostration, little or no thirst, slight sweat, which relieves. Eruptive fevers with Gels. symptoms and tendency to convulsions. Catarrhal fevers with febrile chilliness, cold extremities, heat of head and face, dull headache, suffused eyes, fullness at root of nose, stoppage, etc. A valuable remedy for nervous chills occurring from fright or emotion. A useful remedy for any complaint, especially diarrhoea, which results from bad or exciting news, from fright, or from the anticipation of some unusual ordeal. Gelsemium is invaluable in the treatment of many forms of nervous disease. It is especially useful in paralysis, particularly when affecting single groups of muscles, more especially about the eye, mouth, throat and larynx, also of the chest, extremities and sphincters. The most useful remedy in post-diphtheritic paralysis, the tongue, throat and larynx being chiefly involved. Paraplegia, not of organic origin. May be palliative in locomotor ataxia. Convulsions during eruptive disease; during teething; from suppressed menses; hysterical; puerperal epilepsy. Deep-seated neuralgic pains, especially with other Gels. symptoms. Neuralgic headache beginning in upper cervical spine; vertebra prominens sensitive; pains extend over head, causing a bursting pain in forehead and eyeballs; worse at 10 A.M., when lying; with nausea, vomiting, cold sweat, cold feet. Especially useful in occipital headaches, and when extending to eyes, teeth or shoulders, muscular soreness about the neck, blindness and dizziness. Menstrual headaches; also climacteric. Cerebro-spinal meningitis, stage of congestion, severe chill; dilated pupils; tenderness in occipital region, worse on motion. Congestion of the brain and spine. Orbital neuralgia, in distinct paroxysms with contractions and twitchings of the muscles on the affected side. Iritis. choroiditis. Retinitis. Asthenopia from muscular weakness. Paralysis of the eyelids, also of muscles of the eyes. Double vision. Deafness from catarrh of the middle ear and eustachian tube; also deafness for quinine. Nasal catarrh, especially acute,with symptoms already given. Hay fever. Catarrhal conditions in general excited by warm, moist relaxing weather. In all catarrhal affections the discharges are of watery mucus, never purulent generally excoriating. Disorders of dentition, with fever and other Gels. symptoms. Numbness and paralysis of the tongue. Catarrhal sore throat without exudation. Paralysis of pharyngeal muscles. Hiccough. Passive congestion of the liver, with dizziness, blurred vision, jaundice, etc. Diarrhoea from depressing emotions. Paralysis of the sphincter ani. Partial or complete paralysis of the bladder, in children or in old people. Dysuria from stricture. Urethritis. Seminal weakness, emissions without erections; sexual neurasthenia, after masturbation. Gelsemium is often a valuable medicine in the disease peculiar to women; one of the first remedies in spasmodic or neuralgia dysmenorrhoea; ovarian neuralgia; ovaritis; congestion of the uterus. In all of these conditions, in addition to other indications for the drug, there are usually severe, sharp, labor-like pains shooting into the back, hips and down the legs. It is an excellent medicine for the lying-in room; false labor-pains; they shoot up instead of bearing down; there is an atonic condition, the os widely dilated, pains inefficient or entirely absent; rigid os; severe after pains; puerperal convulsions, with twitchings and other Gels. symptoms. Often useful to control nervous agitation in confinement or abortion,especially nervous chills. Often useful in rheumatism, especially what is termed neuralgic rheumatism, soreness of muscles as if bruised; sharp pains or dull aching trembling; loss of muscular power; gait staggering, a sort of paresis; especially useful in myalgic pains about the neck, mostly in upper part of sterno-cleido muscles, back of parotid glands. In affections of the lower air passages it is generally of little use, except occasionally in catarrhal conditions, or in paralytic or spasmodic states, such as aphonia, spasms of the glottis, spasmodic dyspnoea; threatening paralysis in old people. Nervous affections of the heart, palpitation, oppression, etc., brought on by depressing emotions, such as fright or grief.