Introduction
Lathyrus sativus and L cicera, L. Teori, Kesari (Ind.), pois de brebis (Fr.). Nat. Ord., Leguminosae. b.
Poisonings
1. In 1829-31, the wheat crop failed in a district of India. During these three years the teoree (or kesaree), the Lathyrus sativus of botanists, remained uninjured, and thrived with great luxuriance. In 1831 the natives reaped a rich crop of it form the blighted wheat-fields, and subsisted upon its grain during that and the following years. In 1833, the younger part of the population, from the age of 30 downwards, began to be deprived of the use of their limbs below the waist by paralytic strokes, in all cases sudden, but in some more severe than in others. No person once attacked has been found to recover the use of the affected limbs. All stated that their pains and infirmities were confined entirely to the parts below the waist. They described the attack as coming on suddenly, often during sleep, and without any warning symptom s whatever; and stated that a greater number of young men were affected than young women. (SALEEMAN, Rambles, c., of an Indian Official; from Brit. Journ. of Hom., iii, 257.)
2. Three brothers, aet. 28, 20, and 10 respectively, ate daily for several weeks flour of L. mixed with Indian corn. The following effects were observed:-The gluteal muscles and those of the lower extremities were obviously emaciated, while the upper limbs retained their natural appearance. While lying in bed, extension and abduction of the legs could be well performed, but flexion and lifting up the limbs were difficult. In the eldest patient, the left extremity was decidedly weaker than the r. The youngest could stand and walk; to do either was difficult for the eldest and impossible for the remaining patient, without a firm support. All three when walking threw the chest well forward, the haunches projecting behind, so that they seemed literally to fall from on a part to the other. they also misplaced the feet, which by two of them were brought too close to the median line, and sometimes passed beyond it, causing their legs to cross each other and tangle up; the third and worst affected, on the contrary, walked very bow-legged. The whole of the body rested on the metatarsophalangeal articulations, the heel never touching the ground. Walking backward was similarly effected, but was still more difficult. When told to stand steady, two of them obeyed with great difficulty, and for a few minutes only, if not firmly supported; they swayed widely forwards and sideways, and seemed in constant danger of falling; they instinctively sought to keep their balance by pressing with the hands upon the hips. Shutting their eyes while standing or walking in no wise modified their attitudes and movements. (CANTANI, L’ Art Medical, Aug. 1874.)
3. The first symptom of illness in several cases of poisoning by left cicera, as observed by Brunelli of Rome, consisted of debility and tremor in the legs; the patients had the appearance of being drunk, more especially after meals, when the lathyrus bread had been the only food taken. If the use of the bread were then discounted, the people got quite well again; but in those whom poverty obliged to go on with it for a month at a time, the disease made rapid progress, and after 2 or 3 mos. Presented the characteristic aspect of spastic paralysis. There was great stiffness in the legs and impaired power of walking; the legs were approached to one another by rigidity of the adductors of the thighs; to toes were contracted in flexion, and the heels lifted from above the ground by contraction of the gastrocnemii. Muscular nutrition was not impaired; there was no affection of the sensibility of the special senses, the sphincters of the sphincters or the brain. The tendon-reflexes were exaggerated, more especially as regards the rapidity with which the leg was jerked forwards on percussing the patellar tendon, and less so with regard to the extent of the movement produced. These symptoms are due presumably to sclerosis of the pyramidal to sclerosis of the cord. (ALTHAUS, Brit. Medorrhinum Journ., 1884, i, 984.)
4. The following are the histories of two cases reported by GIARGIERI of poisoning by bread made with flour of vetch (left sat. and left cicera). The patients were brothers.
4a L. A, aet. 17, had an excellent personal and family history; for a year past his diet had chiefly consisted of bread made with vetch-flour. At times he had also eaten the vetches green, causing nausea, vomiting, giddiness, singing in the ears, stupidity, &c. These symptoms gradually increased, and he noticed a tremor of the upper extremities, which became exaggerated on taking up or putting down anything. He gradually lost power in his legs, which felt heavy, with vague pain, formication, and sense of cold. When admitted, he was not able to stand without the support of a stick. On inspection the legs were not wasted, but the abductors and flexors felt hard and contracted. His gait was uncertain and staggering, the right leg beings rather the stronger; he lifted his feet with difficulty, often dragged them, and put them down suddenly and forcibly as if they were heavy weights. The floor, he said, felt irregular, and he was obliged to keep his eyes fixed on the ground to guide his feet. He rested all his weight on a stick. With his eyes shut his movements were still worse, and he felt as if standing between two abysses. Without his shoes, too, he walked worse. In bed he could not sit up without helping himself up with his arms, nor move his toes, nor flex or extend the foot on the leg, or the leg on the thigh, or that on the pelvis completely. sitting on a chair he could not extend his legs, nor cross them. The tendon-reflexes were exaggerated, voluntary movement of the abductors and abductors and rotation of the foot were impossible. Tactile, thermic, dolorific and electrical sensibility were perfect. The temperature was normal. Nothing could be seen in the blood at first or after cultivation. The urine was normal, there was a slight increase of urea.
4b. In M. L.T-, aet. 11, brother of the above, the symptoms were much the same, but less advanced. In the movement of the lower limbs it seemed that the execution of the will was opposed by the spasm of the muscles antagonistic to those which should perform the movements. The tendon-reflexes were exaggerated in both cases. (Lond. Medorrhinum Record, 1883, p. 436.)
5. In the Indian Annals of Medical Science for July, 1859, Dr. Irving reports some cases of poisoning by L. He had assembled together all the lame people from several villages near Allahabad- about 50 men in all. Without exception, they all stated that they had become paralytic during the rains, in most cases suddenly so; and several stated that it had been during the n. Men who had gone to bed quite well had awoke in the m. feeling their legs stiff and their loins weak, and had never recovered. At first the lameness was trifling, and amounted only to unsteadiness of gait and slight stiffness, chiefly of the knees. After a time the muscles of the thighs commenced to ache and feel weak, and also the loins. All denied having had severe pain; while ascribing their malady to the lathyrus bread, the patients considered the conjunction of rainy weather as necessary to produce it, as they had been exposed to the wet about the time of the disease. They had no symptoms of fever, the spleen was enlarged in only one of the patients, and there was little or no wasting of the muscles of the legs. Males were more frequently affected than females. The upper extremities are said not to be affected. It is to be observed that the ground is swampy in the neighborhood where the paralysis prevails, and that the water used is highly impregnated with saline ingredients. (Ranking’s Abstract, vol. ii for 1860, p. 89.)
6. PROUST reports 10 cases of lathyrism seen by him in Algeria, and remarks upon the great similarity of all the cases both in the symptoms, mode of onset, &c. His resume is as follows:-In all the cases the onset was sudden, often after a cold damp n.: the patients suffered form pains in the loins, often extending to the lower limbs and sometimes to the upper limbs, in which sight trembling occasionally occurred. In some cases anaesthesia (sometimes complete) of the lower extremities existed, and all cases more or less motor paralysis; incontinence of urine existed in all the cases and some interference with the generative functions in most. The gait was characteristic and peculiar; the foot was extended and adducted, the heel being raised off the ground; the muscles of the lower limb were contracted, and the deep reflexes exaggerated, both of knee and foot. The anaesthesia and the affection of the urinary and genital organs to lessen or disappear, and in some cases the patients have perfectly recovered without any treatment. Some patients are reported to have had vertigo and weakness of the arms; in animals attacks of suffocation and of wheezing (“roaring”) are common. The author attributed the condition to a transverse myelitis due to haemorrhage, and followed by degenerative changes. (Bull. de l” Acad. de Medorrhinum, S., xii, 829.).
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.