Superior Extremities
Stiffness and pain in the arms, after sleep. Heaviness of the arms (after first 1/4 grain). A peculiar drawing, almost painful sensation in the wrist. Trembling of the hands. Hands somewhat tremulous, after sleeping. Slight trembling and unsteadiness of the hands, while writing. Fingers numb, and both thumbs firmly drawn into the palms of the hands.
Inferior Extremities
Gait insecure and tottering. Gait irregular; staggered like a drunken man (second day). Her legs were twitched up, and she begged that they might be held, as she could not keep them quiet, and felt as if there were worms in them (after four hours). A few twitches of left leg (after one hour). Legs swollen that he could not put on boots (second day). Cramps of the several muscles.
Generalities
Objective. Emaciation. He lost about 15 pounds of body weight. General cachexia. Trembling. Whole body trembles. Twitching of the muscles. Twitching of the muscles of the face and limbs, at times. Both sides of her mouth were twitching; the arms were bent and moved backwards and forwards convulsively; the motions soon ceased but returned (after two hours). Jerking in the whole body. Violent jerking in the arms, head and especially in the face. Convulsive motions; (second day). Convulsive and tetanic spasms. Convulsions. Convulsions of the extremities and face, with partial opisthotonos; convulsions renewed by tickling or pressure upon the skin, without any loss of consciousness. Partial opisthotonos (after two hours). Eclampsia. Drawing and stiffness of the muscles. Patient rigid, absolutely immovable; extremities exhibited no flexibility whatever, and the transient contraction seemed like rigor mortis; indeed, it was with difficulty that the joints could be moved. Muscular system very much relaxed (after four hours). The sensory nerves had almost ceased to act, and the motor portion was also materially affected by the drug (after four hours). Phrenic and pneumogastric nerves considerably narcotized (after four hours). Great weariness (after thirty-six hours). Weakness, etc. Mental and physical weakness and laxity. Weakness of the limbs, small of the back, neck, and joints (after twenty-five minutes). Great weakness. Great weakness of the body, so that he could with difficulty get into bed. Almost unable to walk, for four hours (after two hours); did not recover from weakness for a weak. Could not get up, in morning (second day). Prostration, etc. General prostration. Weakness and general prostration. Muscular prostration complete. Sudden prostration; she had not strength to stand up. Fell suddenly to the ground, as if struck by lightning (after a quarter of an hour). General weakness and loss of power. Some spasms of the facial muscles took place, and she fell back to all appearance dead; face blanched, pulse not to be felt, and respiration not to be perceived; insensibility continued about three minutes. Insensible (after nine hours); (after nine hours and a half). Collapse; on the second or third day after the withdrawal of Morphine there occurs in consequence of the previous slight nutrition diarrhoea, sleeplessness, and yawning, a condition of weakness in almost all patients, the pulse becomes small, the face sunken, the patients cannot leave the bed, and have an expression of complete exhaustion; this simple collapse is not dangerous; it either disappears as soon as the patient begins to take regular nourishment or it passes into a more serious form; this latter commences of ten with alteration of the voice and articulation; the patients are hoarse, they stammer or hesitate in speech; the facial muscles jerk, the tremor of the hands increases; sometimes this serious collapse appears suddenly, even at a time when the results of abstinence, as vomiting and diarrhoea, seem to have subsided, and when it is least expected. Even while the patients are sitting in bed busy with their surroundings they fall back unconscious, and can at first be awakened only by most energetic means; the face becomes sunken or deathly pale, the nose pointed, eyes turned upward and sunken, respiration difficult, sighing, and slow, pulse perceptible only at the heart, or the face becomes deeply red, the eyes shining, pulse 44 and 40, and after a transient nausea and a deathly sensation the patient becomes again unconsciousness; when raised up the head sinks forward on the chest. No response can be obtained either by shouting or irritating the skin; this condition lasting from fifteen minutes to nearly an hour is repeated three or four times at short intervals in twenty-four hours, during which the patient remains only partly conscious, or consciousness returns completely, or the patient may die with symptoms of paralysis of the brain. She retired at 8 P.M., feeling as she said “quite drunk;” in about one hour after she was found completely sensible; she was lying upon her back, her eyes open, a delicate flush in the cheeks, and the lower extremities paralyzed, very cold, and doughy; the extremities were violently pinched, pricked with needles, even after consciousness returned, but with no result; consciousness partly returned in an hour, when the right arm and leg were paralyzed, with violent trembling or shaking; Nux 200 relieved (after a few doses). The patient was found to be apoplectic, unconscious, with stertorous respiration and bluish congestion of the face. Faintness, nausea, and constant retchings, with alternate flushes of heat and cold, for five hours (after two hours). Two attacks of faintness, with dilated pupils (second morning). Faint and almost ready to drop (after two hours and eighteen minutes); recovered in about half an hour after taking a cup of tea, but still felt poorly and sleepy. So much faintness and nausea as to confine her to bed for the remainder of the day, which was for seven or eight hours (after three hours). Dead faint. Fainted several times, so that she was thought to be dead (after two hours). When rising suddenly from stool, he fainted and was soon dead (after three days). Increase of reflex irritability. Reflex irritability appeared to be entirely gone; the finger, and subsequently a feather, applied to the fauces and upper portion of the oesophagus, failed to call forth any reflex action whatever. (She has comparative, though not complete, immunity from pain). At first, an agreeable sensation. A sort of pleasant weariness. Walked three miles, felt very weak going along (after two hours and eighteen minutes). Had felt faint, tremulous, and sick for fifteen minutes (three quarters of an hour after 1/12 grain). Heaviness of the whole body. An indescribable sensation of sickness and discomfort, and a condition bordering on delirium. The nervous system in general is affected; uneasiness, sleeplessness, hallucinations, alternating moods, hyperaesthesia, neuralgia, paraesthesia, trembling of the hands, and increased reflex irritability, and other symptoms of this kind occur. Towards 3 o’clock in the afternoon (about two hours before the usual time for injection), the beneficial influence of the Morphia has usually given way, not (save exceptionally) to positive pain, but to the indescribable sense of depression which Niemeyer’s patients so graphically represented to him by the phrase “katzenjammer;” this feeling disappears almost immediately after the injection. Very ill after the return of sensibility. Oppression. Neuralgia. Neuralgia in various parts of the body, forehead, occiput, and stomach. “Sore all over” (second morning). Sensation as if the flesh were trembling on the bones. Crawling and trembling in the tips of the fingers and in the whole body. After the severe symptoms of the period of abstinence have disappeared, and the patients seem to be convalescent, the whole of the symptoms suddenly break out again; this renewed outbreak has, however, no further influence on the course of the case, and generally lasts only one or two days; in this patient, the relapse was severe, it lasted thirty-six hours. Distinct intervals of two or three minutes between the paroxysms of pain and convulsions.
Skin
Objective. Skin deathly pale. The skin lost its elasticity. Eruption over the whole body (second morning). Eruptions of red pimples. Numerous dark-brownish spots on the back and thigh. Eruption over the face and large portion of the body (second day). Eruption in the right intercostal space, which, except for the absence of pain, resembled herpes zoster. The skin loses its turgescence, color, and tension. The subcutaneous cellular tissue atrophies (though, in some cases, especially in women, it contains fat). The face is mostly pale, ashy gray, seldom deep red, sometimes of a normal color; the perspiration is usually much more profuse than normal, exanthema is very seldom observed. Inflammation of the sebaceous glands, zoster, affecting especially the chin, cheeks, intercostal spaces, occurs from time to time, disappearing and returning, or in some cases persistent. At the point of injection of Morphine abscesses form and infiltrate in the skin, sometimes of a very large size. The patient complains of coldness or even chilliness. Arms and legs covered with red pimples. Subjective. Biting in the skin; this biting is sometimes accompanied by small round elevations. Crawling, tickling, and itching over the whole body. Formications. Formication all over (second day). Itching in the skin; (after thirty-five minutes); (after half an hour). Soon wakened by an itching sensation over the whole body, which induced vigorous and constant scratching; this sensation was felt in every part of the body, from the crown of the head to the soles of the feet; head itched as though innumerable insects were crawling through my hair; face felt as though covered with cobwebs, which I would try to wipe off; bottom of feet felt as if I had chilblains; the legs, arms, abdomen, chest, and back, all itched as though being tickled with feathers, and I was kept busy scratching from head to feet; this lasted till morning, and I should be afraid to say how many times I raked over my entire body with my ten finger-nails; I think that after giving myself a thorough going over, I would drop asleep, but soon be awakened by the itching, and have to scratch more vigorously than ever. I expected to find my body covered with blotches, but my skin was as white and smooth as ever; at intervals all next day and evening, feel here and there, on body, slight itching; and if I were on the sand-beach of Carolina would think it suggested fleas. Constant itching, especially in the face, frequently obliging him to scratch. Violent itching over the whole body, in the evening (first day). Sometimes it produces a troublesome itching of the skin, which in some cases is universal, but in others confined to the nose, neck, loins, and inside of the thighs. Disagreeable itching on the skin, especially on the anus (after half an hour). “Tingling” or prickling sensation in the extremities (soon after third dose). Tingling in feet (after first 1/4 grain).
Born in 1837in Westminster, Vermont. . He was an orthodox doctor who converted to homeopathy
Dr. Allen compiled the Encyclopedia of Pure Materia Medica over the course of 10 years.
In 1881 Allen published A Critical Revision of the Encyclopedia of Pure Materia Medica.