ing ; numbness in the tips of the fingers ; arthritic nodosities on the
fingers. I remember a patient suffering from gouty nodosities ; he
had lived a life of peculiar continence, dwelling on his vices, broken
down in body. Staph, brought out an eruption on his legs as high up
as the knees that looked like a pair of trousers.^ One continuous coat
of crusts which lasted a year before it dwindled, but he was greatly
improved in his body and his enlarged joints gradually improved.
The eruption was yellow, crusty, tough, leathery, and, when lifted up
by the moisture beneath, it had to be cut off like a bandage ; he was
practically crippled ; new crops came out on the parts clipped off. It
was with difficulty that he walked, for the crusts cut him.
Bone troubles, exostoses, inflammation of the periosteum.
Acute articular rheumatism of fast or debilitated men, with shifting
pains. Mercurial bone diseases, ulcers, caries, injuries caused by
sharp, cutting instruments. Nightly bone pains. {Asaf,, Merc,, Sil)
When considering Stram. the idea of violence comes into mind.
One cannot look upon a patient who needs Stram., or who has been
poisoned with it, without wondering at the tremendous turmoil, the
great upheaval taking place in mind and body. Full of excitement,
rage, everything is tumultuous, violent ; the face looks wild, anxious,
fearful ; the eyes are fixed on a certain object ; face flushed, hot raging fever with hot head and cold extremities, violent delirium. In his
anxiety he often turns away from the light, wants it dark, is aggravated especially if the light is bright. High fever with delirium ; the
heat is so intense that it may be mistaken for Bell,, but it is usually a
continued fever, only at times remittent, while the intense fever of
Bell is remittent always,
Stram. is like an earthquake in its violence. The mind is in an uproar ; cursing, tearing the clothes, violent speech, frenzy, erotomania,
exposing of the person. These symptoms are found in continued
fevers, insanity, cerebral congestion. It is useful in violent typhoids.
It is useful in mania that has existed for some time ; attacks of
mania coming on in paroxysms, appearing with more or less suddenness, so that a single attack would look like Bell, but the history differentiates. Bell would hardly be more than a palliative in the first
attack, and the second exhibition of it would do nothing.
When the delirium is not on, the patient has the appearance of great
suffering, forehead wrinkled, face pallid, sickly, haggard. In headpains this anxious look, indicative of intense suffering from meningeal
involvement.
"‘Delirium bland, murmuring ; violent, foolish, joyful, loquacious.
incoherent chattering with open eyes ; vivid ; merry with spasmodic
laughter ; furious, raving, wild ; attempts to stab and bite ; with queerest notions ; with sexual excitement ; fear as if a dog were attacking
him.”