Hyoscyamus

Mind

The mental sphere of Hyoscyamus is one of the most vivid and disturbing in the materia medica. The picture is dominated by delirium, restlessness, jealousy, lasciviousness, and suspicion. The patient may be found muttering, laughing, cursing, stripping naked, or talking nonsense. A classical keynote is talking of imaginary things: about imaginary people, false suspicions, and bizarre hallucinations. [Clarke] details wild jealousy, with suspicion of sexual infidelity in the spouse. [Kent] notes its importance in mania, where the patient shows inappropriate behaviour such as undressing in public, obscene gestures, or erotic talk, often with no shame.

Fear of being poisoned, of being watched, or of being laughed at pervades the mental state. Alternating states of mirth and rage are common. Laughter is loud, idiotic, or uncontrollable. Sleep is disturbed by fearful visions or loud shrieks. There is also loquacity—the patient talks continuously, rapidly changing topics, often in a silly or irrelevant manner. Children may scream suddenly, strike, bite, or become violent without cause.

The classic triad of insanity, lasciviousness, and suspicion makes Hyoscyamus essential in states bordering psychosis, post-ictal insanity, or toxic delirium.

Sleep

Extremely disturbed. The patient may lie with eyes open, start up screaming, or sleep in snatches. Twitching on falling asleep. Dreams are vivid and terrifying. Insomnia from mental excitement is prominent.

Dreams

Frightful, lascivious, or chaotic dreams. Dreaming of thieves, being murdered, or pursued. Children may scream and tremble in their sleep.

Generalities

Violent symptoms. Sudden onset. Spasms, tremors, and delirium dominate. Symptoms often right-sided, worse at night, and during emotional shocks. Suppression of discharges, especially eruptions, is a common etiology.

Fever

Fever is often high, remittent, or intermittent, with strong mental symptoms. Delirium precedes or accompanies fever. The skin is dry, hot, and burning. Profuse sweat follows the heat stage, sometimes offensive.

Chill Heat Sweat

Chill begins in the back, alternates with heat. Shivering even in warm room. Heat is burning, especially in head and face. Sweat is general or limited to head and upper body.

Head

Vertigo, particularly when rising, walking, or bending forward. Head feels heavy, with pulsation in temples. The patient may hold the head with both hands. Headache is often pressive or congestive, with heat and confusion. During delirium, there may be head-banging or striking of the head against walls. Hair is pulled out during attacks of mania. The scalp is sensitive to touch.

Eyes

Eyes are wide open, staring, and glassy. Pupils are dilated, sometimes unequally. Vision is often blurred or double. Photophobia is marked during fever or delirium. Patients may roll their eyes in different directions or have spasmodic twitching of the lids. Eyeballs may jerk or be fixed. Lachrymation may be absent even with wide-eyed staring. [Boericke] mentions a tendency to see phantoms or ghosts during delirium.

Ears

Hears imaginary voices or music. Noises may be interpreted as threatening. In febrile states, hearing becomes overly acute, causing distress. Ears may feel blocked or congested during catarrhal states.

Nose

Twitching or grimacing of the nose may occur. Epistaxis (nosebleed) is common during fever or mental excitement. Coryza with dryness and itching may appear during catarrh, especially in children. Smell may be distorted—odours seem repulsive or overpowering.

Face

Face is red, flushed, and twitching. In states of fear or grief, the face may turn pale. Muscular movements of the face are often involuntary—grimacing, grinning, or frowning. Expression is either frightened or idiotic. Foam may collect around the lips during convulsions. One cheek red, the other pale is sometimes seen.

Mouth

Dryness of the mouth and throat is intense, often with inability to swallow liquids. Speech may be thick, muttering, or incomprehensible. The tongue may be dry, red, or trembling, sometimes protruding involuntarily. In mania, the patient may bite their tongue or lips. There is often salivation, especially during convulsions. Grinding of the teeth is a feature in children.

Teeth

Grinding of teeth during sleep or fever. Pain may be neuralgic, often one-sided. Teeth may be clenched tightly during convulsions.

Throat

Throat feels dry, constricted, and painful. There is difficulty swallowing, especially liquids. Liquids may be regurgitated through the nose. Spasmodic contractions of the pharynx and larynx may cause choking or a fear of suffocation. The voice may become hoarse, lost, or change in pitch during spasms.

Chest

Spasmodic, dry cough worse lying down, especially at night. The patient may cough continuously when reclining, and the cough ceases when sitting up. This is a keynote. Pain in chest from spasmodic coughing. There may be sighing or gasping respiration. Voice may be lost or tremulous.

Heart

Palpitations from fear, fright, or sexual excitement. Pulse is rapid, irregular, and weak in convulsions. Faintness or collapse from emotional shocks.

Respiration

Breathing is irregular, sighing, or sobbing. Spasms of the glottis may cause choking. Patients may stop breathing momentarily during convulsions. There may be groaning respiration in unconscious states.

Stomach

Marked desire for drink, but swallowing is difficult. Nausea and vomiting may occur during fever or excitement. Hiccoughs, spasms, and trembling may follow. Food may be refused in mania. Abdomen may distend with gas. Appetite is variable—ravenous or completely lost.

Abdomen

Tympanitic distension with crampy pains. Gurgling noises and borborygmi are frequent. Pain is spasmodic, especially in hysterical females. There may be a sensation of something moving in the abdomen. Children may cry and clutch the abdomen during attacks.

Rectum

Involuntary stool during convulsions or sleep. Diarrhoea may be painless but copious and offensive. Stool may pass unnoticed. In mania, patient may play with their own faeces or smear them. [Hering] mentions rectal prolapse during violent coughing or spasms.

Urinary

Involuntary urination, especially at night or during seizures. Retention of urine from spasmodic stricture. Urine may dribble or come in spurts. Dark, scanty urine. Strong odour noted during febrile illnesses.

Food

Desire for cold drinks. Loss of appetite in fevers. May refuse food from suspicion. Aversion to water or liquids due to fear of choking.

Male

Marked sexual excitement with lascivious behaviour, exhibitionism, or masturbation in public. Erections may be persistent or absent during acute illness. Genitals may be exposed or handled compulsively. Priapism may occur in toxic states.

Female

Sexual delusions or increased libido. Acts of modesty or shamelessness alternate. Menses may be suppressed by grief or fright. Hysteria around menses is common. Convulsions or spasms may coincide with the menstrual flow. In puerperal mania, there may be violence, confusion, and refusal to nurse.

Back

Back is arched during convulsions. Stiffness or twitching in dorsal muscles. Sacral pain after seizures. Shivering runs along the spine.

Extremities

Trembling, twitching, or jerking of limbs. Convulsions may be violent, with clenched fists and opisthotonos. Fingers may pick at bedclothes. Hands often cold, blue, or clenched. The feet may stamp or pedal during sleep. Inco-ordination of voluntary movements is typical during delirium.

Skin

Skin is hot, dry, and red in fevers. Suppressed eruptions often precede mental symptoms. Hyoscyamus is a remedy for post-scarlatinal mania or suppressed measles. Purplish mottling during convulsions may be seen. Skin may be scratched or torn during delirium.