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 head-pains 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.”
Strange ideas about the formation of his body, that it is ill-shapen, elongated, deformed; strange feelings concerning his physical state. All sorts of illusions and hallucinations. One must distinguish between these states. An illusion is an appearance in the vision or mind which the patient knows is not true. A hallucination is a state that appears to be true. A delusion is a more advanced state, when the patient thinks it is true and cannot be reasoned out of it. Fear and great anxiety on hearing running water.
He sees animals, ghosts, angels, departed spirits, devils, and knows they are not real, but later he is confident of it. He has these hallucinations especially in the dark. At times he has an aversion to a bright light which is painful, and again he must sit and look into an open fire, but this may cause cough and other symptoms.
“Sings amorous songs and utters obscene speech. Crazy with distress, jumps out of bed, acts as if the bed were being drawn from under him. Screams until he is hoarse or loses his voice. Screaches and screams day and night with fever, with forms of mania. Hasty, hurries with all his might if he wants to go to another place.” Violent laughter with sardonic expression on his face.
“Child awakens terrified, knows no one, screams with fright, clings to those near.”
Hyos. has wild, maniacal delirium, but with very little fever. In Stram. there is considerable fever. In Bell. the fever is in the afternoon and evening, nine PM to three AM, and then a remission.
Violent convulsions involving every muscle of the body, opisthotonos, violent distortions, contraction of the limbs, biting of the tongue and bleeding from the passages. During spasms, covered with cold sweat; some times almost as cold as ice; cold sweat in mania; this feature is equalled only by Camphor.
Hysterical convulsions of long standing, associated with spinal trouble; worse from fright. Convulsions in nervous, excitable people brought on by fright.
Puerperal convulsions and insanity. It has the septic nature. Those cases going on for a while as melancholic, low spirited; she believes she has sinned away her day of grace, yet she has lived an upright life; sad; imagines strange things, does strange things, until finally violent delirium comes on; she screams aloud; exhorts people to repent; face red, and eyes flashing; exhorts and prays in incoherent speech. In such cases Stram. should be compared with Veratr.
In cerebral congestions, the delirium subsides into unconsciousness; the patient has the appearance of profound intoxication; pupils dilated or contracted (in Bell. they are dilated). Marked stupor, stertorous breathing, lower jaw dropped. So in typhoid and the low forms of fever, fetor, oozing of blood from the mouth and other passages. Throat and mouth dry; tongue dry, swollen, so that it fills the mouth, pointed, red like a piece of meat, bleeding from the mouth, sordes on the teeth, lips dry and cracked; at times violent thirst yet dread of water. Diarrhea copious, involuntary; abdomen tympanitic, involuntary urination.
Basilar meningitis from suppressed ear-discharge. The Old School have no remedy for such cases. Forehead wrinkled, eyes glassy, staring, dilated pupils and scarcely any fever; awful pain through the base of the skull and there is a history of necrosis about the ear.
Violent headache from walking in the sun, and from the heat of the sun. Aggravated all day and at night the patient must sit up because of increased pain on lying down; he is worse from every motion or jar; eyes fixed and glassy, face flushed, but later it is pale, eyes fixed on a corner of the room, motionless; delirium, says strange things. Pain in the occiput.
High grade inflammation which it carries to the finish. Pus forms abscesses with excruciating pain (Hepar, Merc., Sil., Sulph.). Violent catarrhal inflammations, vicious, septic states. Chronic abscesses, carbuncles, boils, abscesses in the joints, the left hip-joint is a special locality. You will often be able to abort a case of hip-disease, and even when pus is present or fistulous openings have formed it is very useful. Fullness, suppuration, and pain in the cartilages.
Stram. stands alone among the deep acting remedies, in its violence of mental symptoms.
Stram. cures eye troubles and irritation of the brain from over study: in students who are obliged to do much night work to keep up with day lectures. The patient seems almost blind; there is much pain in the eyes in dim light, relieved in intense light. The mental symptoms, cough, head ache, etc., are worse from light.
“Dryness of throat and fauces, not benefited by any sort of drink. Swallowing difficult and impeded With stinging pain in the throat, with pain in the submaxillary gland with convulsions; particularly fluids from constriction of throat.” Choking on attempting to swallow water. It has done some good work in hydrophobia. (Hyos., Bel., Canth., Hydroph.)
In old cases of suppuration of the lungs where the cough is worse from looking into the light, Stram. is often a great palliative and causes no aggravation.
Retention of urine, cannot pass it if he ceases to strain; old men who have lost power over the bladder, stream flows slowly, cannot make haste.
Cardiac affections with great constriction of the chest, mental irritability, delusions as to personal identity, inability to sleep in the dark, great anxiety when on a train going through a tunnel, pulse irregular, heart feeble.
Sleep full of dreams and turmoil.
Eyes fixed upon the dark side of the room away from the light; violent speech with wrinkled face.