Prussic Acid. ***HCN. One measure of the dilute acid of ***B.P. to two measures of rectified spirit makes the 1st centesimal dilution, rectified spirit for all above.
Clinical
*Angina pectoris. Asthma. Cholera Asiatica. Colic (horses). Convulsions. Dyspepsia. Epilepsy. Hemiplegia. *Hiccough. Labour, convulsions in. Stings. Stomach, catarrh of. *Sunstroke. Tetanus. Uremic convulsions. Whooping-cough.
Characteristics
The pathogenesis of *Hydr-ac. is mainly composed of symptoms observed in poisoning cases and clinically verified, but it has also been proved by Joerg and his pupils. *Hcn. is one of the deadliest and most rapidly acting of poisons. Hence its applicability in cases of critical intensity, such as the collapse stage of cholera, when it supervenes on sudden cessation of all discharges, convulsions during severe attacks of illness. It acts powerfully on the celiac ganglia, causing intestinal cramps and colics. Convulsions and paralysis are the leading notes of the medicine’s action. In the convulsions the body is stiffened and thrown back, cramp in nape of neck is very characteristic, breathing comes in paroxysms, jaws set, foaming at mouth, face flushed, bluish tint. ***A.H. Croucher cured a boy, 3 1/2, of convulsions. First attack occurred six months previously. His father’s sister had died of epilepsy. Before the fits came on he could walk well, but could not afterwards. The fits occurred at intervals of about three weeks when a succession of them occurred, each lasting about five minutes, during two or
three days. During the intervals between the fits he would generally scream. In the morning on awaking, patient cried out, then convulsions occurred, body and limbs convulsed, eyelids twitched but remained open, eyeballs turned up and to right. Seemed quite unconscious. *Hcn. 2x, one drop three times a day, increased afterwards to two drops and continued for a fortnight. No more convulsions, but three months later a rash developed all over him. The characteristic blue tint of *Hcn. is apparent after death in some poisoning cases: livid spots on limbs, nails violet. In one case there was a brilliant violent hue all over. The tetanic spasm of *Hcn. is persistent and tonic, and has none of the reflex excitability of the *Nux state. *Hcn. acts most powerfully on the muscles of face, jaws, and back, the risus sardonicus is pronounced, lividity, frothing. It acts on the medulla and through the vagus nerve on heart and respiration. The breathing is irregular and gasping. The heat is greatly disturbed, blueness and coldness of surface, pulse feeble, imperceptible. The patient clutches at the heart as if in distress. The prostration of *Hcn. is profound: drinks roll audibly into the stomach. It cured a boy of four of fever who had this symptom: “when swallowing a teaspoonful of liquid it sounds like water rolling into an empty barrel.” Paralysis attacks first the lower, then the upper limbs. A dry tearing cough worse at night is among the symptoms of *Hcn., and it relieves a similar cough often met with in consumptives. For it must not be imagined that the remedy is only of use in desperate cases of acute illness, it answers to its minute individual symptoms just as truly as does *Camph., but it is only those who know the drug in the higher as well as the lower attenuations who will be able to profit by a knowledge of these. “Feels as if a cloud were going over his brain,” is a symptom Cash removed with *Hcn. in a case of sunstroke. There is much disturbance of the digestion, which is worse after eating. The headache is worse at night and the vertigo worse in the open air. Coldness is a great feature with the remedy, marble coldness within and without. Blue tinge of the skin is also characteristic.
Relations
The closest analogues are Camph., Lauro., and Amygd. It is *Antidoted by: Camph., Coffea, Ipecac., Nux-v., Opium, Verbascum *Compare: Camph. (cholera, coldness), Helod. (coldness), Cicuta. (spinal cord, cramp in nape), Conium (paralysis spreading from below upward), Oenanth. (epilepsy), Lauro. (dry tickling cough, Lauro. has also a cough with jelly-like sputa dotted with bloody points), Lachesis, Tabac. (asphyxia), Helleborus, Solania (paralysis of lungs and heart), Nux (tetanus, but of different type).
SYMPTOMS.
Mind
Depression, discouragement. Anguish and oppression, anguish in the pit of the stomach, fear of imaginary ills. Very great irritability, sadness, peevish temper, incapacity for labour. Inability to think, memory enfeebled, aversion to all mental fatigue. Could not remain in middle of road when a vehicle approached even at a considerable distance, was forced, as it were, against his will, to stand aside without waiting for it to come nearer (after recovery from poisoning).
Head
Head confused and weighty, giddiness with sinking of the body, giddiness, sometimes with a feeling as of intoxication. Dullness of the senses, sometimes with apparent wavering of objects, and of a veil before the eyes, with difficulty to stand on rising from a stooping or sitting posture, symptoms worse in the open air. Vertigo, sometimes with staggering, the patient feels as though something moved in the air and drew him along with it, or else as if everything revolved about him. Feels as if a cloud were going over his brain (cured in a case of sunstroke). Cephalalgia with vertigo, stunning cephalalgia, dull pain in the forehead, beginning at the temples. Head heavy and stupid. Headache, only at night. Pressive cephalalgia in the forehead, or else at the occiput to the left towards the forehead. Violent headache in sinciput and occiput, from vertex to forehead and orbits of the eyes, in the side of the head (right or left) especially in vertex and forehead, at different parts of the head. Tension in frontal region. Shootings in the head, sometimes in one place, sometimes in another. Head confused and weighty, giddiness with sinking of the body, giddiness, sometimes with a feeling as of intoxication. Dullness of the senses, sometimes with apparent wavering of objects, and of a veil before the eyes, with difficulty to stand on rising from a stooping or sitting posture, symptoms worse in the open air. Vertigo, sometimes with staggering, the patient feels as though something moved in the air and drew him along with it, or else as if everything revolved about him. Feels as if a cloud were going over his brain (cured in a case of sunstroke). Cephalalgia with vertigo, stunning cephalalgia, dull pain in the forehead, beginning at the temples. Head heavy and stupid. Headache, only at night. Pressive cephalalgia in the forehead, or else at the occiput to the left towards the forehead. Violent headache in sinciput and occiput, from vertex to forehead and orbits of the eyes, in the side of the head (right or left) especially in vertex and forehead, at different parts of the head. Tension in frontal region. Shootings in the head, sometimes in one place, sometimes in another.
Eyes
Eyes half open, reversed, protruding from the head, immovable, difficulty to move the eyeballs. Pupils dilated and immovable, insensible to light. Eyelids wide open, immovable, as if paralysed, spasmodic quivering in the upper eyelids. Dimness of sight, cloudiness and mist (gauze) before the eyes, amaurotic blindness.
Ears
Aching in the interior of both ears, sometimes with roaring (buzzing) and singing. Hardness of hearing.
Nose
Smarting in the upper part of nostrils. Dilation of the alae nasi, which have a bluish tint. Dryness of the nose.
Face
Puffing of the face, oval visage, visage wears a look of age, pale and bluish, complexion earthy and grey. Expression of beatitude in the countenance. Contortion of corners of mouth, trismus, frightful contraction of the facial muscles.
Mouth
Dryness of mouth. Augmented secretion of saliva. Tongue coated, sometimes white, afterwards dark and dingy, contraction at the root, sensation of coldness on the tongue, burning at the tip of the tongue, paralysis and stiffness of the tongue, which often protrudes from the mouth, loss of speech. Pains in the palate, inflammation of the palate.
Throat
Spasms in the back pat of the throat, and the oesophagus. Scraping in the throat, and in the gullet, painful scraping in the throat, heat in the throat and in the oesophagus, burning in palate, throat, and oesophagus, inflammation of the throat, and of the esophagus.
Stomach
Taste: sweetish, fetid, acrid, and irritating, much gas in the mouth, with taste of prussic acid. Anorexia, repugnance to food. Adipsia, with heat throughout the body, ardent thirst. Loathing, inclination to vomit, vomiting of a black liquid. Pains in stomach, sensation of coldness in stomach, sometimes with lancinations, pressure and squeezing in pit of stomach, with great oppression. Fluids enter stomach with gurgling noise. Great sinking at pit of stomach. Spasmodic contractions in the stomach. Heat and burning in stomach. Inflammation of the stomach and intestines. Pulsative pain in the precordial region.
