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other medicines, I proceeded to prescribe for her according to the symptoms then existing, which were nearly as follows:—
Excessive bearing-down pains, with pressure outward towards the vulva from the whole lower abdomen, accompanied with almost unendurable pains in the back; drawing down from the upper sacral spine, extending also to the epigastrium and stomach. These pains had all the characteristics of true labor pains, returning, if she remained at rest, with regular periodicity, but greatly aggravated by the least movement. She lay on the floor upon a small mattrass, from which she could not be removed (so great was the aggravation from every motion) until the following day.
In addition to the above symptoms, there were severe pressive pains in the head, with dully heavy feelings; pains and coldness in the limbs, particularly in the feet; semi-paralysis, a sort of inability to move or turn herself; nausea, a rising-up sensation from the stomach, producing occasional retching to vomit; frequent, but periodical dyspnoea and oppression of thorax; difficulty of breathing at times very great; nervous weakness and depression; jerkings, not apparently muscular, but nervous twitchings in every fibre of the body, sensible in the pulse, or whenever my fingers touched the flesh, and felt by her through the entire system.
The least food or drink taken into the stomach greatly increased the pains in the abdomen, and the nausea; abdomen sore to the touch, or very sensitive to pressure. She, with some difficulty, informed me that she was laboring under suppression, to which she attributed her sufferings. Regarding it as a case of threatened abortion, to which I knew she was constitutionally liable, I prescribed at first Chamomilla, and afterwards Nux Vomica. The symptoms were soon modified by the administration of these remedies. The pains became less unendurable when she remained perfectly quiet, and I left her,, after about six hours, to get what rest she might be able till morning. During the evening I was informed by her husband that she had taken the Ol. Pennyroyal, to which I at once attributed a large portion of the sufferings above described.
Next day, Monday, found my patient still suffering severely, though much less than the day before. I continued the administration of such remedies as Nux Vomica, Cham., Hyos., and Stram., with very gradual alleviation.
At 12 o'clock, patient still suffering; those bearing-down pains, though less severe, still continue; cannot yet be moved; abdomen still sore; there has been suppression of urine, with great pain in passing water for the last twenty-four hours; there is still coldness of the feet, and of the extremities, particularly to the touch, nervous twitchings continue. As these symptoms appeared to have relation to Ciimphora, and thinking it might prove an antidote to the Ol. Hedeoma, I prescribed Camphora tinctura, a drop in ten spoonfuls of water, a spoonful every half hour for three hours, to be followed by Cantharis 6th, a powder every four hours. In one hour after the administration of the Camphora, was able to remove her to her bed; next morning found her up and at her work, ironing, not well, considerable fever, but* as she said, free from pain except immediately after eating or drinking, the least food or drink producing immediately bearing-down pains and other sufferings. I continued the use of the medicines above enumerated during the week. On Saturday, there were still remaining the following symptoms: considerable nervous twitchings, sense of weakness, sense of weight in the lower abdomen, without. pain, except from motion or from eating, which might still produce slight pains; burning sensations in the abdomen, which was still sensitive to pressure; urine scanty and painful; tongue covered with a white coat; constipation continued. As these symptoms appeared to call for Nux Vom., it was given, or rather continued from yesterday, with one Or two powders of Cantharis; Nux 3, a powder every 4 hours; Canth. 10, two powders. After her symptoms had been so alleviated that she could converse easily, I obtained from her the following detail of her case:—
On Monday she was induced by some person to take as a remedy for suppression of the menses, a large dose of Oil of Pennyroyal, not Ol. Menthae Pulegii, but Ol. Hedeoma. She took a small teaspoonful of the oil in a tablespoonful of warm water. Had great difficulty in swallowing it, followed immediately by nervous weakness, with slight nausea and retching.
After about an hour, bearing-down sensations in the lower abdomen, with outward pressure in the genital organs, and sense of weakness in the limbs. None of these symptoms were very severe, though well marked. Vol. ii. 42
Tuesday and Wednesday. — Periodical returns of all above symptoms, but each day with diminished force.
Thursday.—Took another teaspoonful of the same oil as before. In swallowing it, it nearly took her breath; affected all the nerves; nearly took the use of her limbs, followed by excessive retching, nausea, and straining to vomit; after this, great sense of weakness and prostration.
About an hour afterwards, bearing-down pains, with pressing outward in the utero-vaginal region, accompanied by a feeling of weakness in the limbs, so that she could scarcely stand. These pains continued severe for about an hour, when they gradually subsided. Occasional return of the same symptoms till the next day, but with diminished force.
Friday.—-Uterine symptoms nearly as yesterday.
Saturday.—Same symptoms much more severe; bearing-down pains greatly increased, with nervous weakness; dull heavy feeling in the head in the morning, not continued during the day; also weak, faint feelings, going off when lying down, but could not sit up ;. every thing turned black; excessive nausea, and disposition to vomit; pains periodical, like labor pains, much worse than yesterday.
Sunday.—Same symptoms, but still more severely aggravated; great nausea, with straining and retching ; also nervous twitchings in all parts of the body; at about six o'clock, semi-paralysis of the limbs; could not stand, nor move, nor endure the pain of movement, or of being moved; general soreness; intolerable bearing-down pains like labor pains, which had continued through the day, recur now every few minutes, and extend to the stomach and back: these pains are periodical if perfectly at rest, but recur at every movement of the chest or lower limbs: pain in the back is especially seated in the sacral spine, near the upper vertebra, dragging down from that point to the uterus; excessive pains in the back and in the head; obstinate constipation; coldness of the feet and extremities; shortness of breath, as if an asthmatic attack, a sense as of something rising up in the throat, or, as she expresses it, as if her breast were coming up into her mouth.
Up to this period she had taken no medicines calculated to modify the symptoms. Her health had previously been good as usual, but the symptoms had now become alarming, and I was
called to visit her. I arrived at the house at about half past eight o'clock in the evening. The symptoms, as they then appeared, with the treatment for the ensuing week, I have already given. . The remaining history of the case I shall detail as it occurred each day.
Sunday.—Much improved ; nervous twitchings have for the present wholly disappeared ; constipation, which had continued ten or twelve days without any evacuation, relieved by a free and easy passage; sense of weakness much diminished; almost every way better than yesterday; much better. It is now ten days since the last dose of the Hedeoma was taken, and seven since I was called to attend her, and there still remains the sense of weight in the uterine region, with pressure outward; pains increased greatly by movement; nausea and pains after eating, with a drawing sensation from the upper sacral spine to the uterus; other symptoms have yielded to medicine. Prescribed Ver. 6th, four powders, to be followed, if farther relief be not obtained in twelve hours, by Ars. 6th, a powder every three hours.
Monday.—The first powder of Ver. almost entirely relieved the nausea complained of yesterday; the bearing-down pains and the aggravation from eating subsided during the night, leaving only a sense of weakness, with bearing-down pains on ascending or descending, as in going up or down stairs: passing water is still painful; passes very little, with frequent and urgent desire; never affected in this way before: cutting, burning pains, with tenesmus of the sphincter urinarius; pain at the upper sacral spine continues constant, but much mitigated, and only extends to the uterus when going up and down stairs; cutting pain felt only when she draws a breath, but constant, that is, at every breath not periodical, like labor pains.
Leucorrhoea, both itching and burning, commenced yesterday.
N.B.—A sort of neuralgic pain in the left side of head, with which she had been affected for a month or two, remains unaffected by the whole course of treatment, as yet.
Now, Monday, standing any length of time feels her knees give way; weakness in the knees, especially in the joints.
Wednesday.—The pains in the stomach and lower abdomen and back have been continually subsiding, though they are still troublesome, especially on going up and down stairs, also after eating or
drinking; warm food or drinks affect her much more than cold ones; pains scarcely felt at all when sitting or standing; pain in the head through the forenoon, to-day, subsided in the afternoon; nose bled to-day, which she never had before ; first bleeding of any kind since taking the oil; leucorrhoea still yellow, itching and burning less, but parts still sore from the discharge; pains in the head have been of a shooting, darting character, such as she is not accustomed to have; if she stands long, still finds the knee-joints stiff and weak, with swelling of the calf of the leg; passing water still painful, infrequent, with frequent urging desire; shooting cutting pains, with sense of weight as if something were dragging down; urine very dark, like black tea. This has been a constant symptom since the first dose of the oil, aggravated after the second dose. Cannot stand up and work long at a time, on account of painful weakness of the limbs, and dragging pain or weight in the genitals; very thirsty; bad taste in the mouth; food insipid; prescribed Hyos. 6th, three powders each day, four days, and did not see her again till the following Tuesday.
Tuesday.—Still better; been improving every day; now does not suffer at all if at rest; has been at her regular employment, washing and ironing, for nearly two weeks; still all exertion excites those bearing-down pains from the sacrum to the uterus and vagina, but much less than last week; at times even now severe; washing with wash-board excites them most; has no other pains; leucorrhoea still continues excoriating, itching, and burning; never subject to leucorrhoea of any kind before; not near so bad as last week; tongue still slightly furred, pale white coat; no more bleeding; weakness of the joints nearly well; constant beating in the abdomen near the ovaries, felt most when lying down; soreness, excessive sensitiveness to pressure over both ovaries; soreness and beating only felt since a heavy washing on wash-board last week ; abdomen frequently swollen, tense or tympanitic at the hypogastrium; much flatulence; pains in passing water and dark color of the urine nearly gone; only one or two passages from the bowels a week, but free and without pain. R. Ars. 6th, Nux 6th, two powders each day, alternate days.
She had now so nearly recovered, that my visits were discontinued.
June 1st.—I called again and found all the effects of the Penny