HIPPOMANE MANCINELLA. (L.)

HIPP. MANCINELLA VENENATA, TUSS.

Although the poisonous properties of the mancinella have been very much exaggerated, it is nevertheless a very poisonous tree, which, happily, becomes more and more rare, owing to its being rooted up with great care wherever it shows itself. It is a tree from 12 to 15 feet high, with a trunk having a white and soft wood and covered with a greyish bark. Its branchy top gives it the appearance of a European fruit-tree. Its leaves axe alternate, oval-acute, somewhat cordate at their base, with fine indentations, and a red gland at their apex. They are attached to long petioles; stipulate while young. Flowers monoichous, forming long terminal spikes, the male flowers being above, the female below or at the axilla of the leaves. The male flowers have a bifid perianth whence emanate the stamens, the united filaments of which form a column that supports the anthers. The female flowers have a perianth with two or three divisions and a rudimentary foliole; the ovary is round and superior; style straight, terminating in 6 or 7 red, radiating, reflexed stigmata. The fruit is round, pulpy, from 5 to 6 inches in diameter, umbilicate at the top, and inclosing a wooden kernel with seven monosperm compartments.

The fresh leaves are triturated. When we were informed that a mancinella had been discovered near Rio, we requested Mr. Ackermann, a pupil of the institute, to repair to the spot for the purpose of verifying the identity of the plant, and collecting its juice. Having accomplished his mission, he drunk, a portion of the liquid, on the 10th of January, 1847, in a public sitting of the institute. He was joined in the proving by several of our pupils. Some of the following symptoms were so violent, that they had to be counteracted by antidotes. The pathogenesis of the mancinella is one of the most precious additions which our Brazilian provers have furnished to our Materia Medica.

Prover: M. E. T. Ackermann.

FIRST PROVING.

First day. 1. Merry mood, desire to sing. Is disposed to take everything in good part. Buzzing in the ears and whizzing like the wind, when walking. Urine scanty and whitish. 5. Sensation of heat and trembling in the chest. Constant eructations like volumes of air. Watery vomiting. Violent pain in the abdomen, as if he had been struck by the point of a stick.

Second day. 10. Heavy sleep, and late waking. Evanescent ideas. Sensation of paralysis immediately after rising, his hand trembles a good deal; he is unable to open the door of his room. Absence of thought. Disposed to be silent. Deep tranquility of mind, in the morning. 15. Sadness. Drowsy after breakfast. Embarrassed breathing when falling asleep again. Redness of the skin. Sweat in the palm of the hands whereas the rest of the body is perfectly dry. 20. Pain at the lower part of the head, and weight as if he had knocked it against anything. Small pimples. Beating pain at the left side of the neck. Pain all around the neck like beats with a hammer. Pain at the right side of the head while hearing the strokes on an anvil, he felt as though he were struck with a hammer. 25. Pain at the nape of the neck and forehead when stooping; it is a dull, confused pain which he cannot describe. In the daytime the hands become red. Sense of weight over the eyes. His nose is looser than usual. Pain all-round the head as from a blow after having remained in the sun for a time. 30. Redness and heat of the ears. Alternate hunger and loss of appetite. Weak stomach. Loathing. Profuse urine, but always a little white. 35. Acute pain with weight in the pit of the stomach, for a minute. Eructation during an expiration, like a volume of hot air, which ascends to the mouth with a feeling of oppression. Metallic taste in the mouth. White expectoration. Beating pain in the abdomen after breakfast. 40, Disagreeable sensation while hearing the noise of a saw. When hearing blows with a hammer the counter-shock is felt in the whole body. He alternately lays himself down and raises himself again. Swelling of the veins of the hands. Constant pain all day, in the wrist and metacarpus, as if strings were tied round very tightly, 45. Three slight beats on the arm, as if touched with the finger. Easy stool. The face is yellow and the body red.. Copious emission of wind. Weak all over in the day-time. 50. Two attacks of colic and diarrhoea, with pulling and pinching in the bowels, at midnight.

Third day. Sad, then merry dreams. Everything is unpleasant to him. The headache continues and renders him impatient. Feeling of tenderness and deep pity. 55. Profuse and whitish urine. The chest dilates a good deal, when drawing breath, even with the mouth closed. The chest feels bruised, with embarrassed respiration. The constrictive pain at the wrist shifts to the middle of the arm for an hour, after which it returns again to the wrist.

Fourth day. Lancinating pain in the left temple. 60. Buzzing in the ears, and drumming noise when walking against the wind. Lancinating pain in the chest. Prickings through the heart. The moral emotions are accompanied by an indescribable malaise, beating pain in the chest and loss of speech. When making the least exertion, he is attacked with violent cough and painful prickings in the throat. 65. When commencing to talk, a sudden suffocation and violent beatings in the chest. Suffocation and beatings in the chest when attempting to cough. Beating pain in the head and nape of the neck, with inability to bend the head forwards for the purpose of writing. Weak cheat. Thirst every hour in the day-time; desire for water, with aversion to wine or any other liquor. 70. The weakness increases. Sadness. Colic and diarrhoea. Full and frequent inspirations. Urine clear and abundant, but whitish. 75. Lancinations in the bladder when commencing to urinate, he feels relieved after urinating. Pulling and dragging pain in the bowels.

Fifth day. -Headache. Pain in the chest when making the least motion. The breathing is no longer embarrassed. 80. Extraordinary desire to smoke. Pricking in the feet when sitting. Weakness all over. Pain in the bends of the knees as if bruised. 85. Constriction round the thighs and legs as if a thread had been tied around. Lancinations in the groins. Sexual desire. Continual thirst in the day-time. Dry mouth. 90. Depression of spirits. Sadness. Cold extremities. Profuse and clear urine. Deep sleep in the day-time. 95. Aversion to work.

Sixth day. Dream about ghosts and phantoms. Headache. Sad in the morning. Increasing thirst in the day-time, until evening. 100. Heaviness all over. Profuse and clear urine. Loathing of everything. Aversion to work. Desire to lie down.

Seventh day 105. Headache with vertigo, especially in the morning, after eating a piece of bread. Sensation as of a blow in the abdomen, followed by stool. Formication in the right hip, and lancinations when walking. Continual thirst. Sadness. 110. Clear and profuse urine.

Eighth day. The urine becomes natural again.

Ninth day. The previous symptoms disappear. Active mind, disposed to work. Good appetite.

Eleventh day. -115. Tetter of an inch in diameter on the left arm; it disappears on the following day. Beating pain in the neck, abating for a few moments by reclining the head. Pricking in the mouth when eating bread. Desire to remain lying. Frequent stool. 120. Swelling of the left ankle. Pricking for two hours at the left knee joint.

Twelfth day. Lancinating pain in the head. Heaviness at the head. Pain at the head after thinking, as from bandaging the head from temple to temple with the skin of a bladder. 125. Confused pain in the head when writing. Lancinating pain in the head, as soon as one sets about eating. Contusive pain at the clavicles, when turning the head right or left.

SECOND PROVING.

First day. (The drug was taken at half past seven in the evening.) One hour after, violent headache, with painful lancinations. The pains continued all night, with sleeplessness.

Second day. -130. The headache continues, especially at the temples and above the eyes. Acute pain at the elbow-joints. Taste of blood in the mouth. Rheumatic pain at the shoulder-blade. Repeated, violent lancinations in the right side of the abdomen. 135. Lancinations at irregular intervals, in the left shoulder-blade and muscles, from the left side of the chest. Headache all day. Constant dryness in the throat. Taste of blood in the mouth all day.

Third day. Painful lancinations in the head, temples, and over the eyes. 140. Intense lancinating pains in the left side. Lancinations in the hypochondria and shoulder-blades. The pain at the elbow joint continues. Lancination in the right knee joint. Excessive heaviness and dullness of the head. 145. Constant drowsiness. Incessant headache. Intense, lancinating and constrictive pain in the muscles of the upper part of the right arm, for more than an hour. Continued formication in both feet, especially the left. Taste of blood in the mouth, as if blood had ascended in the throat, and had left the taste of it in the mouth. 150. Frequent and violent lancinations in the abdomen and bowels. Almost complete loss of appetite. Comatose, constantly drowsy. The head feels very heavy, with constant pain in it.

Fourth day. No sleep at night. 155. The headache becomes intolerable. Taste of blood in the mouth. Attack of diarrhoea, with pain and tenesmus. First a natural stool, followed by frequent, painful discharges, first of black, fetid substances, then of a watery liquid ; the attack lasts upwards of two hours. Lancination in the muscles of the right knee, also in the ribs and right side. 160. Pains in the hypochondria. Lancinating pain in the bowels. Lancinating pain in the left shoulder. The headache continues. Complete loss of appetite. 165. No sleep.

ARRANGEMENT ACCORDING TO HAHNEMANN.

1. MENTAL AND MORAL: Taciturn. Deep repose of mind. Evanescent ideas. Merry. 5. Sadness. Feeling of tenderness. Sad, then merry dreams.

HEAD: Heaviness and dullness of the head. Lancinating pain in the head. 10. Pain at the head, as if bandaged all round, after thinking. Headache with vertigo, after eating bread in the morning. Headache, especially in the temples, and above the eyes. Violent headache with painful lancinations. Pain as from a blow all-round the head, when staying in the sun. Weight above the eyes. 15. Pain at nape of neck and forehead, when stooping. Pain and weight at lower part of the head. Lancinating pain in left temple.

FACE, GASTRIC: Face yellow, and body red. 20. Buzzing in the ears. Redness and heat of the ears. Buzzing and whizzing in the ears. Dry mouth. Loathing. 25. Loathing of every kind of food. Loss of appetite. Watery vomiting. Desire to smoke. Thirst every hour, with aversion to wine or liquor. 30. Alternate hunger, and loss of appetite. Pricking in the mouth when eating bread. Eructations, like volumes of air rising upwards. Hot air rises during an expiration. Taste of blood in the mouth. 35. Metallic taste in mouth. Dryness of the throat.

STOMACH, BOWELS: Weak stomach. Acute pain and weight in pit of stomach. Lancinations in the groins. 40. Pulling and dragging pain in the bowels. Sensation as of a blow in the abdomen, followed by stool. Violent lancinations in right side of abdomen. Pains in the hypochondria. Lancinations in abdomen and bowels. 45. Sticking pain in abdomen. Beating pain in abdomen, after breakfast. Flatulence.

STOOL, URINARY, GENITAL: Easy stool. Colic and diarrhoea, with pulling and pinching in the bowels. 50. Diarrhoea, with pain and tenesmus. Natural stool, followed by painful discharges, first of black and fetid, then of watery, liquid substances. Frequent stool. Dartings in the bladder, when commencing to urinate. Profuse urine, rather white. 55. Urine scanty and whitish.

CHEST: Full and frequent inspirations. Weak chest. Contusive pain at the clavicles when turning the head. Sense of heat and trembling in the chest. 60. Suffocation and beating in the chest, when attempting to talk or laugh. Violent cough and painful prickings in the throat, after the least exertion. The chest feels bruised, with oppressed breathing. Lancinating pain in the chest. Considerable dilatation of the chest, when drawing breath. 65. Embarrassed breathing. Prickings through the heart.

BACK, EXTREMITIES : Beating pain at left side of neck, or all around it. Pain at right side of neck as if struck with a hammer. Rheumatic pain at the shoulder-blade. 70. Dartings in the left shoulder-blade and muscles, from the left side of the chest. Beating pain in the neck, abating when reclining the head. Lancinating pain in the left shoulder. Intense darting and constrictive pain in the muscles of the upper part of the right arm. Tetter on left arm. 75. Slight beats on the arms as with a finger. Acute pain at the elbow joints. Constrictive pain in wrist and metacarpus, all day, shifting to the arm. His hand trembles after rising, as if paralyzed. Sweat in the palm of the hand. 80. The veins of the hand are swollen. Formication in the right hip, and lancinations when walking. Constrictions around the thighs and legs. Bruising pain in the bends of the knees. Pricking at left knee joint. 85. Dartings in the right knee joint. Swelling of the left ankle. Pricking in the feet when sitting. Formication in the feet.

SLEEP, &c.: Heavy sleep. 90. No sleep at night. Dream about ghosts and phantoms. Constant drowsiness. Deep sleep in the day-time. Red skin. 95. Pimples. Desire to lie down. Aversion to work. Indescribable malaise, with beating pain in the chest and loss of speech. Nervousness, the blows of a hammer produce a counter-shock in the whole body. 100. Beating pain in the head and nape of the neck, with inability to bend the head forwards. Cold extremities. Heaviness all over. Painful dartings in the head, temples, and above the eyes. Darting in the muscles of the right knee, ribs and right side. 105. Weakness in the day-time.