Conium maculatum. Poison hemlock. N.O. Umbelliferae. Tincture of the fresh plant in flower.
PATHOGENESIS.
HEMLOCK owes it properties mainly to the alkaloid coniine which is formed from piperazidine by substituting propyl alkyl for one of the atoms of hydrogen. its formula is therefore C5 H9 C3 H7 NH. It is the first vegetable alkaloid that was successfully formed by synthesis in the laboratory. Hahnemann says that the primary action of conium is one of rigidity condensation and constriction of fibres, with swelling of the glands and diminution of the senses,” and Teste that its action is primarily inflammatory. The alkaloid coniine causes nausea and vomiting at an early stage, with profuse salivation, and sometimes perspiration, and at the same time there are twitchings and tremors accompanied by stiffness and rigidity of some of the muscles of the limbs. These primary erethistic effects rapidly give place to increasing weakness, and finally paralysis from the action of the drug on the terminations of the motor nerves and the peripheral nerve ganglia. Respiration is accelerated and deepened in the earlier stages, but later becomes slow and laboured and finally ceases while the heart is beating, asphyxia being probably due to paralysis of the terminations of the nerves in the diaphragm. From experiments on animals christison concludes that conium causes palsy, first of the voluntary muscles, next of the chest, lastly of the diaphragm, causing asphyxia from paralysis of the respiratory muscles without insensibility and with slight occasional twitches of the limbs. The dug little direct effect on the heart. It is rapidly excreted in the urine so that its action soon wears off if the dose is not a poisonous one. The mind usually remains clear to the end.
The action of conium in engorging and indurating the glands and altering their structure has been learnt from provings and clinical practice, and would not have been ascertained from physiological experiments or cases of poisoning, as they do not afford sufficient time for these glandular changes to develop.
PROVINGS.
Nervous System.- The provers describe the los of muscular power as being most marked in the lower extremities, the paralysis seems to spread up wards. A heavy, clogging sensation is felt in the heels, the legs become heavy, cold and stiff, movements are clumsy and difficult to control the knees are weak and experimenters tend to fall forwards; gait becomes tottering and trembling and finally impossible. The arms feel weak and heavy weakness and weariness are experienced, especially in the biceps and brachialis muscles and visible twitching are apparent in the muscles of the balls of the thumb. Powerlessness may become complete, so that the patient can move neither arms not legs. Numbness and tingling often accompany the loss of power, or there may be flying stitches or tearings, prickings as of needles, bruised pains or a sensation as if the limb is encircled by a hoop or band but numbness predominates. Pricking and drawing pains are felt in the cervical muscles, aching and shooting between the scapulae, in the lumbar region and beneath the short ribs. The lumbar region feels stiff and disjointed on moving.
Eyes.- An important instance of the motor paralysis caused by conium is that of the ocular muscles as shown by ptosis diplopia and want of power of accommodation. The last give rise to the peculiar vertigo which distinguishes conium. It is an ocular vertigo and arises from inability of the eyes to adjust their focus sufficiently rapidly to approaching or receding objects, a mistiness of sight results and objects seem to quiver. Vertigo ceases on closing the eyes. The patient has good visual definition of fixed objects but to read or follow movements causes vision to be hazy, and brings on the vertigo and possibly nausea. Dilatation of the pupils occurs, usually only after very large doses of the upper lids is an early symptoms. In addition to mistiness of vision, black spots and stripes are seen before the eyes, the eyes water, feel swollen and unnaturally protuberant and there may be diplopia.
The head feels hot, full, heavy and confused, the skin of the forehead burns, severe pains occur in the forehead over the eyes with profuse, acrid lachrymation, and boring tearing, aching pains are felt in various parts of the cranial bones. Numbness, with a sensation of coldness, is experienced on one side of the head and a pain may be felt in the occiput at each pulsation as if a knife pierced it. Drowsiness and disposition to sleep come
on.
Mind.-The patient is hypochondriacal, unable to sustain any mental effort and averse from being near people and hearing them talk. The mind is usually quite clear, but in some cases of poisoning an intermittent delirium, which was of a mirthful kind, occurred, and in others hallucinations.
The face is very red and flushed, with sweat on the forehead, except in advanced cases of poisoning, when it is pale and livid. Tearing pains are felt in the zygomata and the masseter muscles are stiff and ache. There is a crawling sensation or a sensation as of a spider’s web in the right cheek. Profuse epistaxis was noticed in one prover.
Ears.-Ringing and roaring noises are present in the ears, and there is an accumulation of ear-wax mixed with pus or the wax is stained blood-red.
The lymphatic glands in the neighbourhood of the face, behind the ear and down the neck are enlarged and hard; also the sublingual, submaxillary and parotid glands.
Digestion.-The lips are dry and burning, covered with black crusts or blisters; eating cold food causes a drawing pain in the teeth, the tongue is swollen, painful, stiff or paralysed, rendering speech difficult, and the tip burns as from pepper. There is a sensation in the oesophagus as of a round body ascending from the stomach (globus hystericus). Appetite is lost and nausea and vomiting occur. The patient craves coffee, salt or sour things. Sour, empty, offensive eructations with heartburn and heat, griping and pressure in the epigastrium or violent pains in the stomach two or three hours after eating are the principal gastric symptoms. Various stitching pains are felt in the abdomen, particularly in the hypochondria, and there is colic from incarcerated flatus. Shooting pains with burning or coldness in the rectum, and a disposition to painless diarrhoea of liquid stools associated with tenesmus and followed by sweats, trembling and faintness are the principal rectal symptoms. Flatus and stools may feel cold.
The urine is turbid and frothy and deposits a red sediment; there is difficulty in passing it, and the stream is interrupted in its flow. There is often dribbling after urination is completed. An acute, cutting pain is felt in the neck of the bladder and shootings in the orifice.
Sexual.-Conium causes sexual desire without eructations, and emissions without dreams. Prostatic fluid escapes on every change of emotion without voluptuous thoughts, with itching of the prepuce. Coitus is attended with spasmodic respiration. The testicles are swollen and there is increased sweat on the genitals.
In women conium is said to cause enlargement and induration of the ovaries, with cutting pains and induration and prolapse of the uterus. The menses are suppressed, or scanty, and too late. The breasts become swollen and painful before the menses, which are followed by leucorrhoea of thick, milky, acrid mucus with labour-like pain in the abdomen and a paralysed, weak sensation in the small of the back preceding its discharge. Shooting pains are felt in and around the nipples. In one prover, who took a considerable dose, the breasts became atrophic-baggy, flaccid skin alone remaining, and the glands never regained their normal condition.
Respiration.-Conium causes a sensation of a dry spot in the larynx, inducing a dry cough, worse on lying down and at night; even when the cough, worse on lying down at night; even when the cough is loose there is inability to expectorate, so that the patient must swallow what is raised. Sharp thrusts from the middle of the sternum through to the spine while sitting, and drawing stitches in different parts of the chest may be experienced.
Skin.-Itching occurs in any part of the body. Petechiae appear on burning spots with very sensitive surrounding skin, and urticaria is produced by violent bodily exercise. Crescentic patches of dry, scaly eruption are seen. Ulcers may form, but they are usually painless.
Sleep.-The patient does not fall asleep till after midnight and is stupid in the morning. Sleep is unrefreshing and the dreams frightful.
Chill, Fever, &c.-Chilliness and coldness are predominant, and there is a longing for the heat of the sun, but there may be heat, both internal and external, with great nervousness. The patient breaks into perspiration immediately he falls asleep.
The glands are swollen, tingle, and are the seat of painful stitches, especially after contusions and bruises.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,