The patient was lying on his back, in bed; his body slightly inclined to the right side; face and body covered with profuse perspiration; countenance indicating the most intense pain and fear; head thrown back, and the muscles of the neck and back greatly contracted. This opisthotonic condition would last only a short time (the exact time not observed), and then gradually subside. The remission would not be complete before the trimiasmatic symptoms would again return with increased severity. The pulse varied from 90 to 110 beats. The mind remained unimpaired, and also deglutition and articulation, except when the spasm was on him. In about forty minutes he was taken with a fit; he was lying on his back, touching the head only with his head and heels, and in violent tetanic spasm; his legs, arms, and hands were stretched to the widest possible distension; his mouth was gaped o pen, as if kept asunder with a gag; his face was purple; his eyes were puffed; his pupils immovable; his nostrils distended; every muscle of the body in the strictest tension, and respiration entirely suspended. His heart, however, was beating, and with a regularity and tranquillity that, under the circumstances, was very remarkable. He remained in this situation for a minute or more, when the action of the muscles was suddenly reversed, drawing his head and thighs violently together, and jerking him almost off the bed. He now seemed conscious of the imminent danger of suffocation, and turning his eye imploringly to his friends, made the most distressing and desperate attempts to gasp and clear his throat. A little tenacious mucus was finally forced up into the mouth; the spasm of the glottis was relaxed; a long sighing inspiration occurred; the convulsion ceased, and he fell back on his pillow exhausted, but perfectly conscious. This intermission was short, and again the same congeneries of symptoms appeared, perhaps more intensely violent, certainly of longer duration; and thus they were repeated, with almost unabated force and frequency, for three hours. The convulsions, as they came on, were always tetanic in their form, two minutes consecutively, for the first two hours immediately subsequent to my seeing him, and the patient being often unable to utter a word for fifteen or twenty minutes at a time. Once or twice the respiration was suspended for so long a time that I feared that he had ceased to breathe forever. Convulsions, with slight rigidity; she was very sensitive to external impressions, the contact of the cup to the lips being sufficient to produce a paroxysm requiring four men to confine her to the bed, lasting two or three minutes; the paroxysms occurred every five minutes when she was quiet; the least movement or touch was sufficient to renew them immediately. His head became suddenly and convulsively retracted or drawn back; the spasms were violent, and seemed to cause him great pain, as expressed by the varied contortions of his features; the prevailing form of spasm now affecting the trunk seemed to me exactly that which is called the opisthotonos of tetanus; the muscles felt remarkably rigid, not only during the actual spasms, but also during the intervals between them; the spasms would not come on regularly and spontaneously, but during the short intervals that occurred between them, the slightest touch on the surface would reproduce them before the moment of their recurrence would arrive (after one hour). Spasm of the muscles of the neck; when I put my hand under his head to assist him to drink, I could not raise it from the pillow; next, his teeth were so firmly clenched that two men could not separate his jaws; then his knee-joints became as rigid as bars or iron; and, lastly, his body was raised off the bed and rested on the head and heels; the spasms were slight at first, but speedily became terribly severe; they were not constant, but alternated by intervals of repose. A fit came on, indicated at first by a slight heaving motion of the person, the body rising and falling alternately with the spasms. This motion continued slow at first but gradually increased, and with it the patient’s distress and anxiety, until the arms and hands were affected with similar spasmodic action and drawn up to the breast; breathing was suppressed, except only an occasional catching and by short gasps; the head thrown more and more backward, opisthotonos increasing; face distorted by the spasmodic action of its muscles, and rendered ghastly by its variations of color from red to white, and then quickly to a livid or purple hue; eyes staring, and as the fit increased, shaking the body in a fearful degree; the large dilatation of the pupils suddenly appeared, indicating the approach of general muscular relaxation and fatal exhaustion of the vital energies, as the consequences of so terrible a struggle, and such indeed was the case, for with a few faint efforts to breathe, all signs of vitality ceased. Several spasms had occurred, and one was instantly induced upon my offering her a little whisky and water in a spoon. She opened the mouth to receive it, and immediately the teeth were closed spasmodically, and the whole frame, though still rigid, shaken as by a fit of epilepsy. The arms were brought suddenly against the chest, the hands pressing the throat with spasmodic action.
Respiration ceased; the eyes grew more staring, and as if projecting from the head, the pupils dilating meanwhile. Although the interval between the paroxysms, after using chloroform, was at first apparently lengthened, it subsequently grew shorter and shorter. The length of the first was about fifteen minutes, the second nine minutes, the third about five to seven, and so on until there was but little or no intermission of the spasms, and these grew more violent. The fourth or fifth was terrific beyond description, beginning, as the others, with suspension of respiration and clonic spasm of the arms and hands, and a tremulous agitation of the whole body. The color of the face came and went with a rapidity which astonished the beholder, till the florid changed to a purple, and this only in isolated spots with a boundary of distinct white. On the neck, shoulders, and chest, this rapid transition of color was also observed. Added to this was the distortion of countenance, occasioned by the spasm of the facial muscles, giving almost every conceivable variety of horrible expression which the human face is capable of assuming.
And over and above all, the feature most conspicuous, and which gave intensity to the scene of horror, was the eye. The lids expanded to their utmost capacity; the eyeballs seemed fairly to stand out from their sockets, staring with the expression of a demon, while the doubly rapid dilatation of the pupils to their fullest extent gave an unearthly glare that was awful to look upon, forming together a tout ensemble of the terrific expressions such as might aptly represent out truest ideal of the impersonation of all evil. She awoke and screamed out “I am poisoned!” started up in bed, fell back again, sprang up again, vomited, fell back in bed again, beat the bedclothes violently with her arms, became convulsed all over, then stiff, her eyes staring in her head, and her features contorted. Soon, again, she sprang up in bed with a wildly-frightened aspect, uttered a suppressed shriek, fell back in bed, the left side being convulsed; beat the bedclothes with her arms; was oppressed for want of breath, not grasping, but could not breathe; could not inflate the lungs, the muscles of the chest contracting so violently; the eyes prominent; pupils dilated, with a glaring, staring, wildly-anxious gaze; features contorted; mouth drawn to one side; the convulsions spasmodic, agitated twitchings, assuming a tetanic form; she became quite stiff. Spasmodic attack more or less severe; the last of these seemed to be induced by the application of a cup to the lips, and was very intense and prolonged; the patient started suddenly up in bed, his whole frame being in a state of complete opisthotonos; the respiration at first impeded, became suspended, and it was only by the countenance of long artificial respiration that it was restored; the limbs were rigid and the fingers clenched; pupils dilated; during the spasms, evident relief was afforded by forcible extension of the body; in the intervals, there was constant twitches of the extremities. About an hour and a quarter after he had taken some pills, violent screaming; beating of bedclothes with his arms; complained of feeling of suffocation; head drawn back; moving, as by jumping or jerking, both in the head and all over th e body; difficult breathing; eyes projecting; gasped when he spoke as if difficult for him; hands fixed and stiff, asked to be rubbed; twitchings in the arms and body during the rubbing; twitched all over. In taking some liquid, he snatched at the spoon and seemed to bite it very hard; his body was then jerking and jumping; snapped in the same way at a glass containing a draught which was given to him; fit lasted half an hour, then became composed. Twenty-four hours after this attack, from which he perfectly recovered, seized with another and more severe attack, about an hour after taking two pills; stared up; stiffness of neck, which he asked to have rubbed; uttered loud screams; dreadfully convulsed in all the muscles of the body; opisthotonos; complained of suffocation; asked to be lifted up and turned over; could not be done owing to the rigidity of the whole body; quite conscious; heart’s action gradually ceased, and he died tranquilly about one hour and a quarter after taking the pills. Staring every fifteen or twenty seconds as if he felt an electric shock; the spasms all resemble each other, and only differ in degree of severity and time of continuance, the lightest lasting about ten seconds, and the most severe holding on f or five minutes. A description of one will give an idea of them all: He starts very suddenly, and immediately his legs are drawn asunder as far as possible; his body is curved upward, so that his head and heels only touch the floor, a foot or more of space intervening between it and his back; the muscles of the arms and legs are rigid; those of respiration are frightfully affected, so that it is with great difficulty that he breathes at all; his face becomes blue, then almost black; jaws tightly closed, and the stomach, partaking in the general contraction, forces up its contents, which stream in jets through his clenched teeth; at times his hands and arms are free from spasms, and in the more severe paroxysms he used his fingers to force open his teeth and mouth that he might vomit and breathe more freely; he calls upon us in every such spasm to press upon his abdomen to keep his back down to the floor; the opisthotonos seems partially overcome by his action. His spasm has now held on more than three minutes, during which he has not breathed at all; he has lost all consciousness and indeed exhibits all the appearance of a suffocated man; his tongue protrudes; his eyes stand out from their sockets; we can perceive no action of his pulse or heart, and yet the paroxysm holds on notwithstanding all we can do to overcome it; at last the muscles relax and the spasm gives way; he does not seem to breathe; presently reviving under some stimulants, he remarks, “I can’t stand another like than.” He was not without spasms, more or less severe, for any longer time than one minute during four hours. He can lie in no position but on his back; whenever he turns to one side the opisthotonos is terrific, and compels him at once to turn on his back and call for pressure upon his abdomen. Every spasm seemed to him like an electric shock; the moving of a chair or any other noise, however trifling, gave rise to a spasm; he says it seems to him as if the noise itself were material, or that from the nose came something material down his spine; seems as if a stroke of lightning came to him from the place where the noise was produced; the slightest touch, even of a feather, upon his toe gave rise to a hard spasm; when no motion or noise occurred in the room or in the house, and nothing touched him, he seemed more quiet. During the more severe spasms, he felt as if dying from intense suffering all over the body, with heat and intense pain in the head; felt as if he “was passing into death.” We were fully persuaded that the convulsions force seemed to be augmented by any long-continued quiet; he invariably had a harder spasm when from stillness of the room he had remained for a few minutes unaffected by spasm and resting; the force seemed to accumulate. The attempt of the patient to take liquids was followed by so violent a spasmodic fit as to prevent her swallowing it, and to give that apparent dread of water so well marked in cases of hydrophobia. Even after her request for water, on attempting to give it, she would find herself so incapable of swallowing it as to request that its administration might be differed until the fit was over, the effort to place the cup to the mouth being generally sufficient in itself to induce a relapse of the spasm. Lying back in the chair in a very convulsed state, every limb shaking. She was placed in an easy reclining position, and in a short time she partially recovered; but for a considerable period the shaking was so powerful that it took several persons to hold her hands open, which it was thought would be beneficial. There were short intervals of recovery, during which she uttered some exclamations expressive of great pain; but the least motion produced another paroxysm, and in this state she continued for nearly two hours, when she died. Found in a state of convulsions; one of these fits lasted several minutes; the body was thrown out of the bed by the simultaneous contraction of the extremities; the face was swollen and purple; the eyes fixed and looking upwards; the respiration but little effective; the pulse full, small, and intermittent; the surface of the body covered with a cold sweat; after various attempts to swallow, spasmodic action of the gullet prevented the passage of both liquids and solids; during the brief intervals between the attacks, the patient lay perfectly quiet, snoring, and insensible; after severe attacks, within half an hour, he died. Violent spasms like epilepsy. On attempting to rise from a chair was thrown violently backward, as quick as lightening, and remained fixed upon the chair for an hour and a half. Severe spasmodic attack, her body quivering as though under the influence of a galvanic shock, accompanied with difficulty of breathing; attacks increased in violence; when cold water was applied to her lips the twitching returned. Frightfully convulsed her head being thrown backwards by the violence of the spasms, her arms and legs being at the same time affected with severe spasms, and her jaws firmly. Violent convulsions; the spasms contracted and bent the feet and the hands were clenched, too, and died in one of the convulsions, quite black in the face.
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.