While my provings of stramonium have not been as satisfactory as those made with hyoscyamus, the clinical results from using the remedy have been very gratifying. Stramonium is a powerful narcotic and possesses the power of deranging the sensorium and the cerebrum in a marked degree. It confuses the mind, causes headache, vertigo, perversion of sight, taste, smell and false hearing.
A small dose will cause a slight desire to sleep, but poisonous doses produce violent delirium, persistent wakefulness, hallucinations and delusions. The face is usually swollen and red; a sense of suffocation exists in the throat; the limbs tremble, and the patient is inclined to be very whimsical. Stramonium does not cause much fever; it affects the pulse very slightly, and. the. kidneys and bowels are disturbed only indirectly, or from reflex irritation.
The pupils are dilated, the eyes are staring, and illusions always exist. While the mouth is dry and the lips are cracked, there is an abundance of saliva which the patient swallows with great difficulty. The taste is perverted and there is a great craving for water, which when taken even in large quantities does not satisfy.
To a casual observer the stramonium patient and the hyoscyamus patient appear to be very similar; but a careful analysis of the stramonium disease reveals a condition radically different in many of its phases from that produced by hyoscyamus; so much so that, while both remedies exert a beneficial influence upon the sensorium, I have received no benefit whatever from stramonium in a hyoscyamus patient, and vice versa.
To impress upon your minds the prominent stramonium picture I will proceed to give you what I regard as characteristic symptoms, or in other words, the keynotes that will govern you in differentiating between these two very important remedies.
Stramonium has a dullness of intellect, a sense of stupor, great indifference, poor memory, inability to carry on a connected conversation; the patient is very apt, after speaking one or two words, to forget what he was talking about. Hallucinations are usually present and they are very prominent. The patient acts and looks frightened; sees imaginary persons, animals and other objects; looks about the room, under the bed, and in the bed for some imaginary being; attempts to catch or dodge what he thinks he sees; imagines that persons are outside the room calling his name; speaks of having been told certain things by some spirit; fancies, hat he hears music, and when alone converses with imaginary persons. He also imagines that he is dead, or going to be killed, or that the world is being destroyed. He is melancholy one moment and gay the next; the patient wants light, and company, and always dislikes to be left alone; desires to be taken out of the room, but when out does not know where to go, will move a few steps in one direction and then back, and finally seems better contented when he is again in the ward. On account of vertigo, he cannot walk in the dark or when blindfolded. He imagines that he has done some great wrong, or is saying, ” I never did a wrong thing in my life and do not know why I am pursued.” The eyes are wild and staring and have a vacant look. The pupils are always dilated more or less. Unlike hyoscyamus, the pulse is above normal, but as a rule the temperature does not change. The patient will cover his head with the bedding, and sometimes crawls under the bed. He imagines that he sees colors and beautiful visions.
In appearance the face of the stramonium patient is inclined to be bloated; the mouth, tongue and throat are usually very dry and parched, and water does not seem to satisfy them. Practically 1 have found this remedy to be especially adapted to many cases of puerperal mania occurring during and after pregnancy; also in catalepsy, where the patient is constantly talking, but does not seem to have the will power to move the hands and the arms.
Case 1: Mr. E., age forty-three years, farmer. Never had any serious illness or injury. Was not dissipated, used tobacco and stimulants very moderately; no insanity in the family. In May, 1898, he began to act very strangely; looked wild, could not sleep and lost his appetite. He talked constantly about people owing him vast sums of money, said that he was told to kill them if they did not pay him; that he could see ships coming from the old country loaded with his money; and that the spirits were constantly talking to him about his riches.
He was admitted to the hospital in August, 1898. He was very quiet and well behaved, and on most subjects talked quite rationally. The pupils were dilated, and he had a wild stare, refusing to look a person squarely in the face. His sleep was disturbed and the appetite poor. He disliked to be left alone or in the dark, and would become dizzy when attempting to walk with his eyes closed. His pulse was 80, and his temperature normal; he would not speak to others unless first spoken to, and at no time was noisy. When alone he would talk to himself and gesticulate, and sometimes shake his fist. Once he ran away, saying that someone told him that the doctor was going to poison him that night.
We gave him stramonium, which relieved all of his hallucinations very promptly, and as far as I am able to learn he seems now perfectly well. He has a distinct recollection of those hallucinations and says they appeared to him as real then as my conversation does now.
Case 2: Mrs. C., aged thirty-two years; farmer’s wife. Slight build, brown hair and eyes, fair complexion, the mother of three children. She had never had any serious disease or injury, nor did insanity exist in her family.
About the middle of November, 1897, she became pregnant. During the spring and winter she worked very hard, but enjoyed fairly good health, until about the first of May, 1898, when she became very forgetful, could not sleep at night, and was inclined to be irritable, and her physical condition failed. Her appetite was very poor, she was despondent, and would sit for hours in a listless manner.
In July she exhibited unmistakable signs of insanity. She gave no attention to her home and family, was careless about her dress, had homicidal tendencies, would attempt to escape from the house, and it became necessary to watch her night and day. She slept only under the influence of powerful sedatives. She was committed to the hospital July 13, 1898. She was very insane; she could hardly be induced to walk, and it was necessary to almost carry her to the ward. Her eyes looked wild and were always wide open. She was constantly fumbling about the bedding or her clothes, as if searching for something. She would tear her bedding and clothes when not in restraint, but she was not inclined to be nude. She would invariably remove her stockings and shoes when left alone, and at night would take her nightdress off and wrap a sheet around her. Her pulse was 110; breathing quick, and temperature slightly above normal; face full and slightly red or dark red.
When left alone or in a dark room she seemed greatly disturbed, and would pound on the door and walls, and was constantly busy doing something. She talked very little, and never loudly, nor did she use abusive or obscene language. She would not fight, but resisted terribly when being fed, dressed or bathed. She would remain in bed only when firmly tied. During the first five days she did not urinate, but after taking two or three doses of apis mellifica she had no further trouble in that respect.
During the first ten days I attempted to quiet her by the use of chloral and antikamnia, thinking it would be impossible to relieve the mania before the childbirth; but as I failed completely and she was growing more violent, and the hallucinations were becoming more distressing, I gave stramonium with very gratifying results. The change was not rapid, but very gradually her mind cleared, she took sufficient nourishment and passed through an easy labor August 14.
The first day after the birth of the child she was disturbed for a few hours, when she wanted the nurse to kill the baby, as she was too weak, she said, to do it herself. She had no fever, the discharges were perfectly normal, and on the twelfth day she was up and dressed. The stramonium was continued until September 13, when she was discharged cured. We have had several letters from her, stating that she was never better, was doing her own work, and feels as if she were perfectly well.
Excerpted from A Lecture delivered January 17, 1899, by W. E. Taylor, M. D., Professor of Theory and Practice of Medicine and of Materia Medica in the Hahnemann Medical College, Chicago, and Superintendent of The Illinois Western Hospital for the Insane.