Hyoscyamus niger. Henbane. N.O.Solanaceae. Tincture from fresh herbaceous parts.
HYOSCYAMUS and its alkaloids correspond closely, both botanically and chemically, to belladonna and atropine. Functionally its action is quite pronounced, but its range is much more restricted than that of belladonna. For the mechanism of its action reference may be made to that drug and atropine.
The stimulating and irritating effects of hyoscyamus after small or moderate doses are chiefly manifest on the nervous system; sedative effects are noticed as a reaction from the stage of excitement, or after massive doses where the excitement has been masked by the amount of the drug taken.
Nervous System.-(a) Moderate doses cause : Increased but unbalanced mental activity, a feeling of lightness and mobility, hysteria and irritability; suspicious of plotting or poisoning; fears of solitude, of being bitten by animals, of darkness; of water or appearance of it; or of being sold. Twitching of muscles, general restlessness and disturbed sleep, with alarming dreams and frequent waking are present. Many of the symptoms- pains in limbs and joints-are worse from walking, or other movement. The eyes sparkle but there is dimness of vision, as from a veil before the eyes, disturbed colour sense-objects seem fiery red-and things, appear larger than natural. The conjunctivae become injected and the eyes look as if the prover had been crying.
(b) Larger Doses.- As the poisoning progresses from larger or repeated doses, the prover develops a fixed, staring look or an intoxicated appearance. Coincidently there comes on a tendency to irrational and incoherent chattering, fanciful ideas develop, the person makes grimaces and foolish gesticulations and is loquacious. Though thirsty, dryness and constriction of throat prevent drinking. At this stage it appears that the victim may develop into raving delirium, striking and biting those around, especially if opposed; or ludicrous actions may predominate, like dressing foolishly and desiring to go out partly dressed; or the clothes may be torn up and the patient lie naked, or seek to escape from his room. With less violence, a condition resembling satyriasis or nymphomania may arise, characterized by obscene talk and action, and persistent attempts to uncover and draw attention to his or her genital organs. Convulsions may come on.
(c) Massive Doses.- From these or from persistence in the previous doses, drowsiness sets in, soon lapsing into semi- consciousness and loss of special and cutaneous sensibility; at first the patient may be roused but soon he becomes totally irresponsive, completely unconscious and comatose, with death perhaps from asphyxia during a convulsion. Another set of symptoms may develop from the stage of excitement. Mimetic action, like moving the hands as in weaving, or winding wool, playing musical instruments, frightening away imaginary birds, may come on, though this is not so striking as in belladonna poisoning. The early chattering may degenerate into muttering delirium and the mimetic action into quite purposeless movements and picking at the bedclothes. This will be associated with pyrexia, flushed face, quick, failing pulse, shallow breathing, dry mouth and tongue, sordes on lips and teeth, coma vigil and incontinence of faeces and urine, or perhaps retention of the latter. Death may ensue, or possibly quick recovery (from the poisoning).
If these symptom-complexes be considered they will be seen to counterfeit several clinical conditions. The milder complexes several the temporary wandering of acute fevers, influenza, scarlet fever or even pneumonia, &c. More severe complexes correspond with cases of delirium tremens of different degrees of severity. Others resemble puerperal mania, or erotic mania of general paralysis, nymphomania, &c. Typhus-like symptoms arising in the course of enteric, puerperal sepsis, typhus fever, malignant scarlet fever, surgical sepsis, or pneumonia will cause hyoscyamus to be considered as a possible remedy, as compared with arsenic, the serpent poisons, baptisia, ailanthus, bryonia, &c. For the maniacal delirium, with even more violence, but less of the septic element, stramonium may replace hyoscyamus. The mental conditions which hyoscyamus seems to correspond may be summarized as follows : it produces “acute mania, acute delirious mania, acute confusion,” and resembles acute alcoholic confusion. Some of its symptoms resemble the trembling, weakness and convulsive movements of general paralysis of the insane, and stages of encephalitis lethargica, and melancholia, with delusions of being a lost soul, and puerperal insanity with erotic symptoms.
Unless the dose overwhelming or be persisted in the effect is evanescent, i.e., from the toxicological point of view; from the clinical, the effect is also short-lived and the dose requires repetition if the phase of the disease or disease or disorder for which it is prescribed is not also evanescent, either naturally or as a result of the curative action of the drug.
Head.- Hyoscyamus may be useful for passing stages of different maladies where the symptoms only temporarily correspond with those of the drug. An acquaintance with the remedy will prevent its appropriateness being overlooked, and its use will bring a relief which might otherwise be missed. The headache of hyoscyamus is associated with giddiness, disturbed vision, dazed, heavy feeling, loss of memory, yet uninvited memories crowd in upon the patient. The location of the headache is chiefly frontal, where a dull, stupefying pain may alternate with fine shooting (left) or spells of violent, tearing pain. In addition to those pains there may be (a) a sensation as if “the brain” shook and splashed when walking, (b) shooting over the right eye when coughing, (c) throbbing and aching worse from stooping. Headache in the room (not in the open air) may be experienced.
There is gnawing pain in the scalp, worse from moving and touching it; turning the head causes pain in the vertex and the nape; also there is stiffness in the nape, and the muscles of the back of the neck feel tight, as if too short on flexing the neck. Epistaxis may occur.
Digestive System.- The tongue feels numb or as it burnt, worse when speaking and inspiring; toothache, worse on the left side or in single teeth, now here, now there, worse from masticating, after taking cold, in the morning, with heat of the head. The throat is parched and has a constricted feeling, causing choking and spasms on attempting to swallow fluids-“water fear.” This, with the twitchings, cramps of neck and back, and convulsions, caused Hahnemann to recommend it as one of the best remedies for hydrophobia, and it has been used for convulsions in children from fright or teething, and in women during and after parturition. For epilepsy the indications are unreliable as most of the symptoms recorded as produced by the drug were in epileptic and insane patients under treatment. Ravenous hunger is a feature and cramps in the stomach relieved by vomiting. The abdominal pains are chiefly of the muscular walls-tenderness and bruised feeling-after coughing or cramps. There may be frequent urging to stool or alternating conditions of delayed and frequent evacuations. There may be diarrhoea, slimy or watery, followed by constipation, when the stool may be hard and coated with mucus. During the delirium or the “typhoid state” already referred to, stool and urine may pass involuntarily; or there may be straining in both areas.
Respiratory System.- The chief clinical use of hyoscyamus in this sphere has been for a short, dry tickling, spasmodic cough which comes on when lying down at night, and necessitates propping the patient up. Sometimes the paroxysms simulate whooping-cough, and there is dyspnoea between the attacks.
Extremities.- There are a number of rheumatic or muscular and joint pains, aching or cramp-like (glutei or calves). Some dull pains in elbows, wrists, thighs and feet, were worse when at rest, but most of the limb pains were worse on walking or movement. Sciatica has been treated with some success by this drug. Spasms of the toes even when walking, have been relieved or cured by it; also tremblings, senile and mercurial.
The skin symptoms include pustules (face, &c.), general scarlet rash, becoming dusky; also boils and ulcers. In the typhus-like state similar skin eruptions would be confirmatory; without the general symptoms of hyoscyamus other and more strikingly similar drugs would be required.
A feature of the sweating is that it occurs chiefly during sleep; it may be general or limited to the face and head.
(1) Mental states, varying from mild excitement, through mild wandering, chattering and incoherence to delirium, violent or muttering. Such may be found in acute fevers, and in delirium tremens.
(2) Maniacal conditions, puerperal or not, with symptoms like nymphomania, obscene action or conversation, and indecent exposure of the genital organs-a delirium or aberration, not a responsible sexual manifestation. (3) Suspicions and fears : of a plot, of being alone, of the dark, of poison, of being sold, &c. (4) Local spasms, twitchings, cramps and tremors. (5) Convulsions from various causes in children or adults (see text). (6) Typhus-like states. (7) cough, dry at night when lying; also from excessive talking, singing, &c.; or after eating and drinking. (8) Disturbed sleep, late going off, frequent wakings, alarming dreams; from excitement or worry in daytime. (9) Ailments from fright, disappointed love, worms (in children), parturition (in sensitive subjects).
Night (cough); lying down (cough); cold air (toothache); eating, drinking, singing, talking.
Warm air (cough); shaking head or sitting with head bent forward (? meningitis), headache; vomiting (colic).