Datura stramonium; the thorn apple. N.O. Solanaceae. A tincture is made from the leaves while the plant is n flower, or from the whole plant and seeds.
STRAMONIUM closely resembles belladonna in its action on the central nervous system, and on the peripheral nerves; it had a more marked effect on the heart, which soon becomes irregular under its influence. Relaxation of the muscular coat of the bronchi is a very striking result, and it is much used as an antispasmodic in asthma and, in combination with datura tatula, lobelia, &c., forms a useful palliative on antipathic principles. For this purpose it is used as cigarettes, or the powder is burnt and the smoke inhaled. in this sphere the “dual action” of the drug is acknowledged even by non-homoeopathic authorities. For Pereira allows that ” it has proved highly injurious . . . . aggravation o the dyspnoea” being produced (Hughes, “Pharmacodynamics,” p. 834).
The gross effects of the poison are furious delirium, amounting to violent mania; and irritation of the throat- inflammation and muscular spasm-and of the skin. the stage of excitement is followed by stupor and general paralysis. In one fatal case symptoms like hydrophobia, coupled with marked hyperaemia of pharynx, oesophagus and larynx, with redness and swelling of the vocal cords occurred.
Mild poisonings and the provings enable one to classify the mental symptoms somewhat as follows :-
(1) SYMPTOMS OF EXCITEMENT OR STIMULATION.
(2) SYMPTOMS OF DEPRESSION.
(3) HALLUCINATIONS. It is not suggested that these symptoms occur in “water- tight compartments.” While there is a certain progression or sequence, due to varying susceptibility of different tissues or to the dose of the poison, the excitement group preceding depression, some features of each group may coincide. This is especially shown in the persistence of some of the evidences of excitement into the stage of depression. Hallucinations may belong to either group or stage.
(1) EXCITEMENT, in crescendo order:-
(a) Loquacity-simple talkativeness-not the rapid change of subject noticed in lachesis cases;
(b) A proud, haughty demeanour;
(c) Desire for light and company(in contrast to hyoscyamus cases);
(d) Sexual excitement; tendency to indecency of talk and gesture;
(e) Aimless laughter, snatches of singing, dancing about;
(f) Talk becoming incoherent;
(g) Definite delirium; twitchings, mimetic or graceful movements;
(h) Struggling to get out of bed or to escape from control;
(i) Mania ; attacks of rage, violence, striking with any available weapon, attempts at biting; tearing of clothes, breaking furniture; or praying and preaching excitedly and incoherently;
(2) DEPRESSION :-
(a) Stupidity, indifference;
(b) Dulness of senses; melancholy; religious melancholy;
(c) Memory fails-cannot remember what was intended to say; uses wrong words and names;
(d) Has strange ideas-thinks his body is too big, or that it is double, deformed or cut up; misjudges size and distance- objects seem too large;
(e) Nervousness ; fears, of dark, going through a tunnel ; of strangers-thinks they are attacking him ; terror;
(f) Lapses into unconsciousness, with dilated pupils, carphology, stertorous breathing, dropped jaw, &c.
(3) HALLUCINATIONS AND ILLUSIONS :-
(A) Fear of being in the dark and fright on a wakening; because environment is misinterpreted; does not recognize people; misjudges actions and intentions of people;
(b) Sees small black objects-bugs, crawling things, dogs, &c., or sees “ghosts” or devils, later thinks they are real;
(c) Terrified at seeing horrible (imaginary) images, or animals pursuing him;
(d) Hallucinations, worse in the dark, become fixed delusions.
Head.-The head is hot and flushed; there is throbbing in the forehead and vertex, and convulsive movements or spasms drawing the head to the right side. The vertigo is worse in the dark; patient staggers or falls to the left or backwards, reels as if drunk.
Eyes.- The eyes are prominent and staring, look brilliant, with dilated pupils, or look wild or terror stricken. conjunctival injection usual in any acute phases of poisoning. Hallucinations and illusions (up sup.).
Face and mouth.-There is a look of terror on the face, also frowning, twitching,grimaces and irregular spasms causing risus sardonicus. The face is florid, even turgid and swollen, or between paroxysms of delirium and during apyrexia, pallid, anxious and haggard. The tongue becomes swollen, dry and stiff; speech is difficult, stammering and unintelligible, either from state of mouth or from disturbed innervation. Dribbling of glairy or bloody saliva takes place, sometimes due to the tongue having been bitten.
Throat.- Dysphagia from dryness and from spasm; spasm are excited by attempts to drink, or even from looking at bright, reflecting surfaces. Drinking water, even if possible, does not relieve the dryness of mouth and throat.
Stomach, &c,- There is violent thirst, not relieved by drinking; thirst for sour things; dread of drinking. Hiccup, nausea and vomiting occur, being the most characteristic. The abdomen may be distended, but is not usually hard or tender; there may be colic round the umbilicus. The bowels are constipated, and the faeces, if any, are dry.
Urinary Organs.- The lesions are functional and of nerve origin. The secretion of urine may be practically in abeyance. In cases where the secretion is maintained there may be paresis of the sphincter or vesical walls, shown by incontinence of urine (dribbling) or enfeebled stream.
Sexual Organs.- Here, too, the condition is mainly a neurosis; in both sexes unbalanced excitement occurs, with definite aberration in the mental sphere. In women nymphomania may be induced. Menorrhagia or metrorrhagia may coincide with the erethism, the blood being dark, clotted and of strong odour. It is said that there may be a strong body odour in such patients apart from menstruation.
Respiratory System, &c.- The voice becomes hoarse and croaking or high pitched, in either case indistinct. A feeling of suffocation from constriction of the chest (spasm of the respiratory muscles) causes hurried breathing and desire for the open air. These spasms may be brought on by attempts at drinking, along with the spasms of the throat muscles. A dry, spasmodic cough may also be noticeable. Palpitation, with rapid, full strong pulse may be present, or a soft, feeble, irregular pulse.
Neck and back.- The spine, chiefly the cervical region, is especially sensitive to touch, pressure may cause screaming, raving and arching of the back. There are drawing pains in the dorsal and sacral regions.
Limbs.-Twitchings, of single muscles, of groups or of portion of a lime take place, hands, feet, forearm, legs, &c., convulsions, local or general, and choreic movements may be simulated. In febrile cases subsultus tendinum and picking at the bedclothes occur.
Skin.- a bright scarlet erythema may spread all over the body; the skin feels hot and dry, or there may be a cold sweat over the body, after convulsions and when coma is coming on.
Sleep.- The patient, soon after falling asleep, cries out as if frightened, he tosses restlessly about, and twitches and when coma is coming on.
Sleep.- The patient, soon after falling asleep, cries out as if frightened, he tosses restlessly about, and twitches and screams.
Fever.- The pyrexia of stramonium is continued (bell. remittent). Even during a chill, while the body and limbs are cold, the face may be red and hot; cold sweat may follow, but the patient dislikes being covered (secale).
Summary.- There is general diminution or suppression of secretions; twitchings and convulsive movements as described, sometimes apparently purposive or graceful. Reflex irritability is increased, spasms being brought on by attempts at drinking, by looking at bright surfaces.
Co-ordination is impaired, walking in the dark being difficult, the patient staggers or falls. Delirium, furious and maniacal, may occur. In febrile cases, later on, subsultus tendinum and carphology may come on.
While consciousness is still present the patient is full of fears, and has many hallucinations and illusions. Sore throat and scarlet rash over body are very constant features.
The application of the foregoing n acute cases is fairly easy. Wherever delirium, verging on or amounting to mania is present, the drug is useful, if only for the time and palliatively. It is a great thing in acute febrile and septic cases, where restlessness and delirium are exhausting a patient and exposing him (or his attendants) to physical case for stramonium is one of acute delirium, the effects of this drug very closely simulating those of acute alcoholic poisoning, or other drug-delirious states. It follows the case throughout, and at hardly any stage can be a misfit.
Next in frequency it may be required with similar mental manifestations in typhus, enteric, pneumonia, puerperal mania, and eclampsia, especially where the fears like stramonium have been noticed before violent delirium or convulsions set in. For meningitis from ear trouble, for erotomania, especially nymphomania, it is also useful.
It has been useful in hydrophobia, to which some to its symptoms furnish a very close simile.
For epilepsy apparently due to fright, for chorea and for stammering, it has been prescribed with good results, but the correspondence of symptoms of drug and disease must be carefully established, or time and trouble may be wasted. In melancholic states, with violent agitation, stramonium may come in.
Headache from exposure to the sun, worse on lying down, on motion (especially jarring) and with nervous fears may require this remedy. When the gaze seems to be fixed on one spot, which causes fear or perplexity to the patient, when he looks anxious or even wild, and may be talking at random, stramonium may be relied on.
The headache and mental symptoms are certainly liable to be aggravated by a bright light, but Kent says (sub voce) pain in the eyes is “relieved by an intense light.” A bright light on the other hand may bring on a fit of coughing in phthisical cases; this may be a reflex like sneezing due to a bright light; stramonium has proved a useful palliative.
For spinal meningitis due to traumatism, if convulsions come on, with fears, twitchings and delirium, this remedy must be considered.
In less acute cases, ex. gr. children with a hyperaesthetic nervous system, who are easily frightened, who are terrified of the darkness or even of going into a tunnel, this drug may be extremely useful, though they may have no named malady; and for sleeplessness and awakening in a fright, twitching in sleep incontinence of urine.
Some cases of scarlatina, even with suppression of urine, with characteristic mental symptoms, may be saved by stramonium, who would otherwise be lost from exhausting delirium.
Insomnia from overstudy, especially night work, with the headache described, may require stramonium.
(1) Fear of being alone or in the dark, on awakening.
(2) Talkative, singing and laughing foolishly, tendency to wander and become incoherent.
(3) Or melancholy-religious or not.
(4) sexual excitement and indecency.
(5) Illusions and hallucinations-sees black, crawling objects or horrible animals and frightening visions.
(6) Delirium becoming violent mania, followed by exhaustion and coma.
(7) Spasm of throat muscles, induced by trying to drink, or even by sight of water, or bright objects.
(8) aggravation of mental condition after sleep (as lach.).
(9) Violent delirium in febrile complaints.
(10) Painlessness is characteristic of most complaints.
(11) Hydrophobia, chorea, convulsions in children.
(12) Post-partum sepsis, with mania.
From trying to drink (throat spasm), from bright lights, bright reflecting surfaces (cough, spasms), after sleep (mental), from pressure (back), lying down and motion- especially jarring head.
Light and company.