Stramonium | Materia Medica by Carrol Dunham
Dr. Dunham (1828-1877) graduated from Columbia University with Honours in 1847. In 1850 he received M.D. degree at the College of Physicians and Surgeons of New York.
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THORN APPLE OR JAMESTOWN WEED.
Indigenous in the United States and Europe. So common in our waste places about the cities that cases of poisoning with it are by no means uncommon.
Goats eat the leaves with impunity. Cows, if affected by it, are not easily affected. But after eating it, their milk has proved poisonous to children.
This drug, the action of which resembles very closely in many particulars that of Belladonna, was brought into prominent notice as a remedy by Stoerck, of Vienna, who advised its internal use in mania and epilepsy.
“If,” says he, “Stramonium produces symptoms of madness in a healthy person, would it not be desirable to make experiments in order to discover whether this plant, by its effects on the brain, in changing the ideas and the state of the sensorium (i.e., of the part, whatever it be, which is the center of action of the nerves upon the body), should we not, I say, try whether this plant would not restore to a healthy state those who are suffering from alienation of mind; and if, by the change which Stramonium would cause in those who suffer from convulsions, by putting them in a contrary state to that in which they were, would it not cause their cure?” This was written in 1762.
By allopathic physicians it has been successfully employed against epilepsy in Stockholm, and by both allopathic and homeopathic physicians against mania.
The following general summary of its effects is taken chiefly from Trousseau and Pidoux:
In moderate doses, Stramonium produces slight vertigo and a disposition to sleep; the muscular energy is lessened; the sensibility is blunted; dilatation of the pupil; slight obscuration of vision; acceleration of pulse; elevation of the heat of the skin ; thirst; a slight burning in the fauces. Generally the bowels are relaxed; the urine is more abundant than common; there is copious perspiration, provided there be neither diuresis nor diarrhoea.
But, in larger doses, vertigo, general debility; some degree of stupor; soon the vision becomes obscured; there is enormous dilatation of the pupils, agitation, spasms, furious delirium, continual hallucinations, obstinate insomnia, high fever; the skin is hot, dry and often covered with an eruption closely resembling that of scarlatina, burning thirst, and very painful dryness and constriction of the pharynx; often impossible to swallow; cardialgia; vomitings; sometimes diarrhoea ; frequent desire to pass water, with but little or no urine.
When the poisoning is to prove fatal, the extreme agitation is succeeded by collapse, coldness and death. In the more happy and more frequent cases, the hallucinations cease little by little, delirium comes to an end, and of this whole collection of formidable symptoms there remain only the dilatation of the pupils, the obscuration of vision, and sometimes a transient blindness. The delirium and the blindness, however, have been known to persist for several days, and even for weeks.
The delirium is sometimes gay, sometimes sad, but is always accompanied by singular hallucinations and fantastic visions.
Our more exact knowledge of the effects of Stramonium is derived from Hahnemann’s proving of it. (“Materia Medica Pura,” vol. iii.)
Upon the vital force Stramonium exerts a very powerful and characteristic action.
1. The sensorium is both exalted in activity, as the vigilance shows; and perverted in its functions, as we gather from the mania, the hallucination and the fantastic visions which universally result from it.
The special sense of vision is perverted, as witness the double vision and the peculiar false vision, as well as the colors seen by the patient; and it is blunted, blindness resulting.
The general sensibility is blunted; the function of voluntary motion is affected; convulsive motions of the extremities ensue, particularly of the arms and of the face. Isolated groups of muscles are convulsed.
The function of the secreting surfaces of various organs is suspended. The secretion of urine is suspended, and so is that from the surface of the intestine, by large doses.
2. On the other hand, the organic substance is hardly affected, save in the eruption which covers the skin, and in the greenish diarrhoea which sometimes follows a small dose.
3. There is no marked periodicity of action.
4. The peculiarities of the action of Stramonium are the following: The mania and delirium are not attended or followed by high fever; the hallucinations are real as in the second stage of delirium tremens; the convulsions affect the arms more than the lower extremities; and consist in a trembling and convulsive groping forward with the hands; finally, the peculiar false and double vision in which the patient, looking at an object, sees it repeated a little above and at the left side of the original, or in which only a small part of an object is to be seen at once, as for example the nose on a person’s face, etc.
The suppression of urine is a noteworthy symptom.
The convulsions are often provoked by looking at a light, or upon a reflecting surface as a mirror or water, and also by contact.
The limbs feel as if separated joint from joint.
The vertigo of Stramonium resembles that of Belladonna, and makes the gait unsteady.
No special headache is ascribed to it. Considerable congestion of blood to the head is produced, with heat and spasmodic drawing of the head hither and thither.
The face is generally swollen, has at first a pleasant expression, except for the fixed stare of the eyes; subsequently the face becomes distorted.
Vision is much affected, colors are not correctly distinguished. Black objects generally appear gray, everything seems to be tipping over; the letters on a printed page seem to move, or they and other objects appear double. There seems to be a fog before the eyes, or it seems as if one looked through a glass of turbid water. Sometimes absolute blindness ensues. The pupils are enormously dilated. The eyes are sometimes red, and there is involuntary discharge of tears. No organic lesions.
The mouth and throat are very dry, although the tongue is moist. Violent thirst but inability to swallow, because the throat seems to be constricted. The vocal organs seem to be paralyzed, the tongue trembles, the patient stammers and murmurs unintelligibly; or is absolutely dumb, and indicates with signs the objects of his desire; or, if he speaks, his voice is shrill, fine and high-pitched, but he has to make great effort to get out a word.
Notice that this is without fever, without swelling or any pain within or without the throat. There is here, then, no laryngitis, but simply a convulsion of the laryngeal muscles and vocal chords.
The taste is bitter; vomiting of green bile occurs on motion, or even on sitting up in bed.
Great anxiety in the epigastric region. The abdomen is distended, with rumbling and gurgling in it, and painful to pressure.
As a rule, the evacuations are suppressed, but we find urgency to stool yet no stool. Urine is suppressed; yet there is urgency to pass water.
The menses are increased. The flow occurs in large coagula, with drawing pain in the abdomen, in the ilium and other parts.
With regard to the respiratory organs, we find no cough as by Hyoscyamus and Belladonna, but respiration is difficult and constricted, generally with anxious respiration and lividity of the face. A pressing pain in the chest, which is provoked by talking, with difficult respiration; it is hardly possible to draw in the breath. These symptoms are of great interest in connection with the empirical use of Stramonium in asthma.
In the trunk and extremities hardly any symptoms are observed, save the convulsive movements, sense of lassitude in the back and drawing pains in the spine, the sacrum and the ilium.
The sleep is either solid and sound and deep, with loud snoring, the patient lying on the back, with the eyes fixed and open; or else it is light, with troublesome dreams and disturbed by startings, cryings and wakings.
The fever is moderate. The chill, if it occur, is general, with twitching of single groups of muscles. Heat is chiefly in the face, or, if it be general, it is characteristic that, during it, the patient carefully covers himself up. (Ignatia.) Sweat copious.
The disposition resembles a genuine mania, distinguished by loquacity, hallucinations and ridiculous attitudes and gestures; the hallucinations completely possess the patient.
But sometimes this mania amounts to absolute rage, with disposition to strike and bite, and alternating with convulsions.
Remarks on practical applications of Stramonium may best be prefaced by the following remarks from Hahnemann’s introduction:
During its primary action, Stramonium produces no pain, properly so called, though it does cause very unpleasant sensations.
The primary effect is to increase the activity of the voluntary muscles, and to suppress all the secretions, a state exactly contrary to the secondary effect which paralyzes the muscles and in which the excretions are superabundant. For the same reason, when taken in a proper dose, it soothes spasmodic muscular action, and restores the course of the suppressed excretions in many cases where absence of pain predominates; this plant, therefore, can only cure homeopathically when the morbid state corresponds with its own primary effect.
But, and here I speak from experience, what incomparable curative power has not the homeopathic application of the mental derangement excited specially by Stramonium exerted in analogous mental diseases arising from other causes; and how salutary is this plant in convulsive affections similar to those which it provokes. I have found great benefit from it in certain epidemic fevers having symptoms analogous mentally and physically to its own.
But, as mania shows various modifications, so we cannot always obtain a cure for it by one remedy. In certain cases we must have recourse to Belladonna, in others to Henbane, in others to Stramonium, according as the symptoms correspond homeopathically with one or the other of these three drugs.
Moderate doses only keep up their action thirty-six to forty-eight hours; weaker doses a still shorter time.
In mania, Stramonium is a most valuable remedy. The form which requires it has less fever than that of Belladonna; more convulsion, and especially convulsion of isolated groups of muscles; more hallucination. It has more fever than that of Hyoscyamus, less loquacity, no quarrelsomeness, but, on the contrary, good nature; the hallucinations are real, not, as under Hyoscyamus, half real, bewildering the patient.
CONVULSIONS. Stramonium has been found useful in epilepsy as well as in other forms of spasmodic disease. It is remarkable, however, that the convulsions produced by it are partial, rather than general, affecting the arms rather than the lower extremities; affecting, also, isolated groups of muscles. Thus, we have twitchings of the extremities and of the facial muscles, jerkings of the head, etc.
From these symptoms we should be inclined to draw an indication for the use of Stramonium in chorea; and it has been found the most useful drug in the materia medica in this malady.
It should be noted, however, that chorea being almost always (at least in my experience) associated with, if not based upon, a depraved and vitiated state of the nutrition involving changes of organic substance, no such remedy as Stramonium, which does not modify nutrition nor alter the organic substance, can be relied upon as the sole or even the chief remedy; I have, accordingly, though finding Stramonium very useful to moderate the severity of the purely nervous phenomena, been obliged to trust to such remedies, alterative in their character, as Calcarea carbonica, Natrum muriaticum and Sepia, or Sulphur, for a permanent cure.
In delirium tremens, it is easy to see that Stramonium would be clearly indicated in the second stage too. It has been tried and with admirable success.
The spasmodic affection of the pharynx, and the fact that the various convulsive affections are brought on by the sight of water, etc., suggest the use of Stramonium in hydrophobia. Hahnemann affirms that it has been successfully used in some forms of the disease.
Stramonium has been of greatest service in suppression of the urine, without pain or discomfort, such suppression usually occurring in the course of long fevers, E. G., typhoid or typhus, not a simple retention of urine in the bladder; in such a case Opium would do better.
Likewise in suppression of urine after miscarriage or after labor, where the desire to pass water is great but there is no ability to accomplish it, Stramonium will give speedy relief, provided always the case be not one of retention from a mechanical cause, such as retroversion of the uterus.
In affections of the respiratory organs, Stramonium has acquired a great reputation for the relief of asthma. It was used as follows: The dried leaves were smoked in a pipe, sometimes alone and sometimes with niter; giving often relief but sometimes causing damage.
In scarlatina, Stramonium stands next to Belladonna. The eruption is generally reported as being very like scarlatina. The fever is less than that of Belladonna. The throat affection is less than that of Belladonna. At the same time, from the suppression of urine, we may infer that Stramonium affects the kidneys more than Belladonna. It is thought that Stramonium suits now a larger class than heretofore. (See the article of Dr. Wells on scarlet fever, ” American Homeopathic Review,” vols. iv., v. and vi.)
The following case of poisoning from the application of Stramonium leaves to an ulcer came under my own observation:
A mechanic, about forty-four years old, whose health had suffered greatly in consequence of a severe bilious remittent fever and the heroic doses of calomel prescribed for its cure, had been under my care several weeks for large irritable ulcers upon both legs. I was called in haste, early one morning, and was informed that my patient was “not right in his mind.
I found him dressed and lying on a lounge. He recognized me and immediately apologized for not rising, stating that his limbs were not under his control; and, in fact, I found afterward that they were paralyzed. His face was covered with patches of an irregular shape, not elevated above the rest of the skin and of a brilliant fiery red color. The conjunctiva was injected, the pupils immensely dilated; the whole expression of the eye was brilliant, restless, suspicious and roving. The brow was corrugated. The appearance of the patient suggested mania and I might have at once pronounced it a case of delirium tremens, had I not well known the temperate habits of my patient. The tongue was moist, the papillae enlarged and projecting through a soft white fur. The limbs were motionless. The arms on the contrary were constantly reaching forward and upward with an uncertain tremulous motion, as if the patient were endeavoring to seize some object which he indistinctly perceived in the air. As I sat observing him, he suddenly turned toward the wall, exclaiming, “There are those bugs! help me to catch them!” “What bugs?” I asked. “There,” he replied, “a long train of bed-bugs, and after them a procession of beetles, and here comes crawling over me a host of cockroaches.” He shrank back in much alarm. Then suddenly he turned to me, saying, “I believe I know they are not really bugs; but, except once in a while, they seem real to me!” This scene was many times repeated. For some time I was at a loss to account for the condition of my patient. At length the peculiar, almost convulsive, motions of his upper extremities while the lower extremities were nearly paralyzed, together with the aspect of the face and the mental condition suggested Stramonium to my mind. His family knew nothing of his having used it, but when he heard me mention the name, he pointed to his legs, where, on examination, I found a quantity of the bruised green leaves which he had applied to the ulcers, it seems, the night before, in the hope of relieving pain.
The poisoning not being very serious, I contented myself with removing the leaves and allowing the effects of the poison to pass away without administering any antidote.
The mental symptoms produced in this case by the Stramonium so closely resembled those of the second stage of delirium tremens, as to point strongly to Stramonium as a valuable remedy in that disease.