Cuprum Sulphuricum

[SULPHATE OF COPPER, BLUE COPPERAS, BLUE VITRIOL, BLUE STONE.]

This salt of copper is so commonly known, that a description is almost unnecessary. It is found as a native product and is readily soluble in water. Its crystals are slightly efflorescent. Use is made of it in various mechanical pursuits.

Professor Moschka relates the following case in the Wiemr Med. Wochenschrift, 1871 :

October I2th F. H., aged sixteen years, swallowed a quantity of pulverized lilue vitriol, stirred in water; within half an hour he was brought into the hospital. We found a small, frail youth ; his skin was pale ; the lips pale, bluish at the corners and internal edges, the tongue coated, bluish and cold.

Cold extremities, with cyanotic nails ; the pulse small and rapid, and some little decrease in the temperature of the body. The patient complained of being thirsty, of a choking in the throat, coppery taste in the mouth, pain in the epigastrium, which is very sensitive to touch. An emetic was given, followed by magnesia in water, and milk and white of egg. He vomited matter of a bluish color, soon mixed freely with mucus and magnesia.

After

CUPRUM SULPHURICUM. 51

half an hour, four pultaceous, greenish-yellow stools, without the least trace of blood. The scanty urine, passed per catheter, contained neither albumen nor blood. During the night the patient was very restless, groaned, and complained in the morning of severe headache, pain in the epigastrium, and burning in the mouth and oesophagus. He vomited no more, and voided but small amounts of urine, containing blood, albumen and some bilious pigment.

October 14th The skin and conjunctiva are of icteric color; rapid pulse; dimin- ished temperature of the skin ; pallor of the visible mucous membrane. Great weak- ness, oppression in the chest and restless tumbling about in bed. Pultaceous, brown- red stools, streaked with blood ; tenesmus.

Scanty and bloody urine. Action of the heart is weakened; a slight friction-sound at its base; the liver is enlarged, the abdo- men drawn in, and the lower extremities flexed over the abdomen. During the following few days the icterus decreased; but the patient grew weaker constantly, and died with all the symptoms of total collapse on October 18th. Examination after death showed : Great pallor of the substance of the brain and emptiness of nearly all its vessels; some serum at the base of the brain.

Pallor of the mouth, throat and oesophagus. Brownish coating of the tongue ; emptiness of the jugular veins; presence of a slimy fluid in the larynx. Pallor of the tongue, with swelling of the left lower lobe, which was filled with a foamy fluid, the left upper lobe cede- matous ; a similar condition existed in the corresponding lobes of the right lung. The pericardium contained some serum, which gave no reaction to copper; the heart was of usual size, flabby, soft, and the valves closed ; absence of blood in the cavities; a few fibrinous coagula were found in the vena ascendens.

There was no fluid in the abdomen; the stomach and intestines were full of air; the peritoneum was of slaty color. The spleen normal in size and usually full of blood. The liver was of usual size; the capsule smooth; the substance yellowish-brown, soft, friable, fatty, moderately full of blood ; in the gallbladder only a few drops of dark, thick bile. The kidneys were enlarged, the capsules tense ; the cortical substance yellow ; the pyramids compressed and of a pale brown.

The stomach was greatly distended, its coating tough ; it contained about two pounds of a brown, somewhat acid fluid. Its mucous membrane was thickened and covered with tough mucus along the large curvature, of a rather greenish color. On the base of the stomach was a round eschar of the size of a small penny, where the mucous membrane was changed to a dirty- brown, flocculent, and easily-detached eschar, showing plainly the muscular coat after its removal. The mucous membrane of the small intestines was normal ; that of the colon swelled, pale gray, containing slimy, thin fecal matter.

The most noteworthy symptoms of this case are the icterus, the fatty degeneration of the liver, the eschar in the stomach, and the absence of blood in the vessels of the brain and lungs. The gastric symptoms are so decided that you cannot overlook them ; and the condition of the kidneys and the urinary symptoms will not escape your observation.

As a remedial agent this salt of copper resembles the acetate so closely that any especial indications would be a mere repetition of what I have already given you. Suffice it to say that this particular preparation is not as extensively used as the acetate and the metal itself, although it has all of the characteristics which belong to cop- per. If it has a particular value, I believe it to be in the treatment of inflammatory conditions of the stomach and of the bowels, and in organic derangements of the liver, accompanied by profound gas- tric disturbances.

Topically it has been applied to inflamed eyes with good results ;

62 CURARE.

and surgeons still use it to suppress excessive granulation or "proud flesh." As an escharotic its action is, however, not very powerful. It is a very active emetic and as such may be useful. Ten grains of the salt, dissolved in an ounce of warm water, given every ten min- utes, will usually produce prompt unloading of the stomach.

In a case of poisoning with any of the compounds of copper, an emetic should be given at once to unload the stomach ; afterward albumen or the white of eggs in milk or sugared water ; iron filings have likewise been recommended ; the iron decomposes the salt and precipitates the copper in the metallic state.

The stomach pump may be used instead of the emetic to relieve the stomach.

CTTKAKE.

[WOORARA. INDIAN ARROW-POISON.]

Few remedies are shrouded in more darkness and uncertainty. The well-known fact, that the wild tribes of uncivilized southern countries had in their possession a poison, whose effect was said to be unavoidably fatal, soon became known to the travelers, who ex- plored their home and studied their habits. Their exaggerated reports created a due amount of interest in the poison, which at last terminated in efforts to utilize it for medicinal purposes.

The very manufacture of the poison is guarded with the utmost care by the conjurers who possess the secret. Much of their influ- ence in their tribe is due to their superior knowledge and shrewdness, and all possible precautions are taken, to secure a continuance in power by guarding their secrets from the scrutiny of anyone unin- itiated, native or foreigner. Hence, information on this point must .be taken with a fair degree of allowance.

The poison acts by absorption into the blood ; if taken into the stomach it requires a large dose to produce fatal results. Introduced into the circulation it is very rapid in its action, producing almost instantaneous effects upon the wounded animal, by causing paralysis of the motor-nerves, affecting them from the periphery to the centre.

A hedgehog was wounded by a poisoned arrow brought from Guiana. Death was not instantaneous, for the animal, which was very slightly wounded in the hind leg, breathed for some seconds; but the hedgehog was quite insensible, and as soon as it had been

CURARE. 53

pricked by the dart, it allowed the narrator to lay it on its back, and to place his ringer on the ball of its eyes, without shrinking.

Of all animals the ai sloth is the most tenacious of life. "An ai was wounded in the leg and put down upon the floor, almost two feet from the table. It contrived to reach the leg of the table, and fast- ened itself upon it, as if wishful to ascend. But this was its last advancing step ; life was ebbing fast, though imperceptibly ; nor could this singular production of nature, which has been formed of a texture to resist death in a thousand ways, make any stand against the wourali.

First one fore-leg let go its hold, and dropped down motionless by its side ; the other gradually did the same. The fore- legs having now lost their strength, the sloth slowly doubled its body, and placed its head betwixt its hind-legs, which still adhered to the table ; but when the poison had effected these also, it sank to the ground, but sank so gently, that you could not distinguish the move- ment from an ordinary motion ; and had you not known that it was wounded with a poisoned arrow, you would never have suspected that it was dying.

Its mouth was shut; nor had any froth or saliva col- lected there. There was no subsultns tendinum, nor any visible alteration in its breathing. During the tenth minute from the time it was wounded, it stirred, and that was all ; and the minute after, life's last spark went out. From the time the poison began to operate, you would have conjectured that sleep was overpowering it." (Mr.

Waterton in Wood's Uncivilized Kaces of the World.)

The extreme virulence of the poison and its striking effects led the physiological schools to the belief that in it they would find a remedy of rare power and of unusual efficacy in the treatment of tetanus. It is hardly necessary to add that these bright dreams were never realized. Physicians of our school were not slow to fol- low the example of their older neighbors, and while they went to work somewhat more systematically, I arn by no means sure of their being more successful in reaching positive and practical results.

We have provings of the substance, for I cannot consistently call it a drug ; and the proving of Dr. Houat contains no less than 474 symptoms. I believe that I am right in doubting the wisdom of intro- ducing into our materia medica substances, whose very mode of preparation is shrouded in darkness and which are no more and no less than a mixture of juices of various plants, without any recognized formula and each of them possessing well-defined drug-effects of its own. Why not prove Hostetter's Bitters or a mixture of various

54 CURARE.

indigenous remedies, supply it with a name of its own and palm it off as one of the grand additions to our list of therapeutics? Truly, there is a lack of judgment and consistency somewhere.

Mr. Freeman (Monthly Horn. Review, Sept., 1865,) advocates the use of curare in : paralysis of the parts, supplied by all the motor- cranial nerves, pain being absent ; lateral paralysis after apoplexy ; paralysis from mechanical injury ; nervous debility ; debility of aged people; debility following exhausting illness.

Dr. Charge recommends it in cough, spasmodic in its nature, fol- lowed by vomiting and fainting, aggravated dry inhaling cold air, by laughing, moving and eating. Roughness, dryness and burning in the whole throat ; loss of voice or great hoarseness. Yellow, gray, greenish, dark expectoration. Difficult respiration ; stitching pains in the right side ; precordial anguish, with palpitation and stinging pains in the heart. It is said to be useful in

IRREGULAR AND CAPRICIOUS MENSTRUATION, pre- ceded by uterine colic, accompanied by headache and general malaise and followed by burning in the vulva and great sexual excitement.

Dr. Hardenstein [Am. your. Horn. Mat.

Med., vol. iv., page 104,) gave curare30, one dose every sixth night, with very great benefit, and after the unsuccessful exhi- bition of a large number of other remedies, to a patient, who presented the following symptoms : Patient, aged thirty years, has been in bed sixteen months ; funnel-shaped ulcer of the os uteri whose upper diameter was one inch. The whole neck of the uterus was of a hard, horny character, dark-red, purplish and looked as if mice had gnawed all over the. surface of the ulcer.

There were two small opaque pustules of the size of a pea on the inner edge, containing in the middle a translucent, bloody fluid. Ichorous, corroding, fetid discharge ; indurations of the abdominal parietes toward the inguinal and ovarian regions, excessively painful to the touch. Vaginal corrugations tumified, inflamed and very sensitive ; hsemorrhoidal fissures and swell- ing of the rectum and anus. General appearance of scirrhous cachexia.

The di- gestive functions were entirely broken down. Diarrhoea, with constant urging, fetid, thin, mush-like feces, excessive pain in haemorrhoidal tumors, bearing down in the uterus, with sharp, shooting stitches ; burning in and around the womb. Dull, anxious expression, with clay-colored skin ; aching in all the limbs ; rigors ; sleepless- ness ; despair. The uterine disorder seemed more particularly benefited by the ex- hibition of the curare.

HYDROPHOBIA — Curare is now frequently used by the "regu- lar" school in the treatment of hydrophobia.

CYCLAMEN EUROPIUM. 55

CYCLAMEN" EUBOP^ETTM.

[SOW BREAD. NATURAL ORDER, PRIMULACEiE.]

A native of the south of Europe, Tartary, and cultivated in gar- dens. Root large, orbicular, compressed, brown, sending out many branched fibres ; leaves radical, angular, somewhat heart-shaped, three inches long, of a deep-green color above, and a reddish purple underneath; flowers drooping, purplish, sweet-scented. After the flowers have fallen off, the flower-stalks curl spirally, inclosing the germen in the centre ; and, lowering it to the earth, repose on the surface of the soil till the seeds are ready to escape.

AVe gather the root in the fall, from which we obtain a brownish tincture.

Hahnemann has left us some interesting provings of the cyclamen europaeum which reveal in unmistakeable language the acro- narcotic character of the drug, and likewise its therapeutic range of action.

CEREBRAL GROUP.

In the cerebral group, cyclamen has a stupefying effect upon the brain, which impairs even the sensitiveness to impressions, and the faculty of recollection. Franz, for instance, reports this symptom : "His mind seems to be in a constant state of stupefaction, he is unable either to feel glad or sad, although his feelings really are as though he had passed through some great affliction ; it is only when stirred up that he seems to act more knowingly, he then seems like one who is just roused from his slumber and only understands im- perfectly what had been going on around him."

The pains which this drug excites in the brain, are a feeling of pressure, or a rheumatic drawing or darting stitches, at times in one, at other times in the other temporal region, or likewise in the vertex. These cephalic symptoms must be viewed in connection with the orbital symptoms, the symptoms of the digestive apparatus, the rheumatic pains which this agent excites in the extremities and back, the fever symptoms ; in one word, the whole pathogenetic series of the drug has to be kept integrally in view, in order that a clear comprehension of its particular groups may be obtained. It is evident that the affections with, which this drug is in specific homoe- opathic rapport, are of a rheumatic and neuralgic character, and that

56 CYCLAMEN" EUROPIUM.

the abdominal ganglionic system and the cerebral nerves are the chief recipients of its irritating action as a drug, and of its curative influence as a remedial agent.

VERTIGO, which is one of the characteristic effects of cyclamen upon the brain, has been cured in several instances with this drug. Dr. Eidherr likewise reports a case of

HEMICRANIA of several years' standing ; the attacks came on every week or fortnight, and were complicated with menstrual diffi- culties. The patient took cyclamen3, was freed from her headache, and menstruated regularly afterward.

ORBITAL GROUP.

The effect of this drug upon the sense of vision is rather marked. Our provers state that it causes dilatation of the pupils ; obscuration of sight, with oppressive stupefaction of the whole head ; the sensa- tion was as if mist had been before the eyes, and his eyes were almost closed as if by force ; the upper lids were swollen.

These symptoms are reported by Langhammer, one of the very best, most careful and conscientious contributors to the Materia Medica Pura.

Franz reports : Dryness and pressure in the eyelids as if they were swollen, with intense itching stinging in the lids and in the eyeballs.

DIMNESS OP SIGHT— Hahnemann states in a foot-note, that Simon Paulli found this drug useful in dimness of sight, when attended with a general want of action in the organism, probably in consequence of repeated exposure, cachexia induced by living in damp dwellings, without sufficient ventilation, light, fresh air, and perhaps made worse by the use of hard, indigestible food, or food of mediocre quality. The dimness of sight is of an amaurotic charac- ter; the mistiness is accompanied with dilatation of the pupils.

STRABISMUS AND DIPLOPIA.— In the Vienna provings it is likewise stated that cyclamen causes and will therefore cure strabis- mus and diplopia. Here, too, it is seen that these pathological states are intimately connected with a more general irritation of the cerebral nerves.

In one of the cases of strabismus reported as cured, the affection came on in conse- quence of a fall upon the head. A few days after the accident, the child was seized with spasms, which caused and were followed by strabismus. After the ineffectual exhibition of arnica the patient was cured at once with a few doses of cyclamen. In cases of strabismus or diplopia for which cyclamen is specifically adapted, other signs of cerebral irritation may be present, such as vertigo ; a relation of mutuality may likewise exist between these forms of cerebral irritation and the menstrual functions.

CYCLAMEN EUROPIUM. 57

DENTAL GROUP.

This drug excites peculiar pains in the teeth. One provcr reports : Violent stitches in the last molar tooth of the upper jaw ; tearing pain in the three last molar teeth, as if the teeth were to be torn out. This explains the following symptom reported by Franz and which shows that in

RHEUMATIC TOOTHACHE, this agent may prove useful ; the symptom reads: *'A dull, drawing toothache, which had lasted the whole night, passed off in a minute."

CHYLO-rOIETIC GEOUP.

We have: nausea, with flow of water in the mouth ; a rough and slimy feeling in the mouth, as though he had not rinsed his mouth early in the morning ; empty, or occasionally sour eructations ; eructations after supper, always terminating in hiccough, during which a fluid which has an acrid and burning taste, rises in the oesophagus ; aversion to food, after eating ever so little ; aversion to bread and butter ; insipid taste of the food; drowsiness after dinner ; pressure and a feeling of repletion in the pit of the stomach ; pinch- ing, cutting and stitches in the bowels and epigastric region ; burn- ing pressure in the epigastrium, as if a portion of intestine were loose, and a pulling were experienced in the adjoining parts ; pinch- ing, followed by soft and yellow stool, after which the bowels remain constipated for three days ; a painful drawing and pressure at the anus and in the region of the perineum, as if an abscess were form- ing.

RHEUMATIC DIARRHCEA — These symptoms may induce the use of cyclamen in rheumatic diarrhoea ; they may denote a more or less habitual cachectic condition of the bowels, brought on perhaps by the same causes to which we have adverted under the orbital group.

ENTERALGIA Cyclamen has been used in enteralgia.

Dr. Strupp reports three cases of enteralgia, cured by cyclamen. The first case was that of a man, aged thirty-five years, of robust appearance. The attacks came on at night, with much rumbling in the bowels and a feeling of great illness.

Walking about seemed to relieve the pain somewhat. He had ceased to take food or drink at night. After several years of useless treatment he received four doses of cyclamen14, one dose a day, which was followed by a complete cure. The second patient, a man of sixty years of age, was delicate, had an eruption of dry tetters on the face, sunken eyes and red nose.

The attacks commenced at seven in the evening with a gnawing pain in the bowels, spreading all over the body; they were somewhat relieved by walking. He also had been unsuccessfully treated. Four doses of cyclamen1*, as above, cured him. The third patient had suffered long with gnawing pains in the bowels and had been abroad without receiving permanent benefit.

His appearance

58 CYCLAMEN EUROPIUM.

denoted much suffering; the face was bloodless and the features were sunken; he complained of great debility, loss of appetite, a lifeless feeling in the bowels, and. constant gnawing pains in the abdomen. He could take but little nourishment, as all food caused great discomfort and swelling of the abdomen, with frequent eructa- tions of flatulence. The passages from the bowels were rare and hard, and were difficult to expel ; at times he had thin, watery and slimy diarrhcea. The continued use of cyclamen12 cured him entirely.

URINARY GROUP.

These same causes likewise operate in the urinary group, causing a more frequent secretion of a whitish-looking urine, and a stitching pain in the urethra near the meatus, during an emission of urine. We may recommend cyclamen for

ENURESIS, more especially the enuresis of strumous and cachec- tic children, whose bowels likewise incline to discharges of mucous and papescent stools preceded and perhaps accompanied by pinching nain.

, SEXUAL SYSTEM.

MENORRHAGIA. — This drug affects the sexual system, more especially that of women, similarly to its action upon the bowels and bladder. The ancients even employed it as an abortive agent. Its use may therefore be advised in the monorrhagia of scrofulous and cachectic individuals, the menses recur too frequently, and the patient inclines to feel chilly.

In the Vienna provings we find the following symptoms recorded : The menses are profuse, too frequent and too early ; they come on with a violent pain in the abdomen, after having been suppressed for a long time ; the menses are complicated with a pain resembling labor-pain ; the blood flows very profusely, is very dark and clotted.

These few symptoms confirm the action of large doses and justify the iTse of this agent in menorrhagia. Guided by the above-men- tioned pathogenetic effects, we may likewise prescribe this agent for

DYSMENORRIIOBA, more especially if the menses make frequent but unsuccessful or only partially successful attempts to make their appearance. If cyclamen is indicated, we may generally look for such signs of cerebral irritation as we have mentioned. Even

AMENORRHGEA may yield to cyclamen, if the suppression is caused by rheumatic exposure, and the menstrual ilow is superseded by vertigo, obscuration of sight, congestion to the head and heart.

PRURITUS. — Cyclamen has been used in the treatment of pru- ritus.

Mrs. R., aged fifty-one years, has suffered greatly during twenty years from prurigo vulva;. Her case had become considered incurable. She got along very well during

CYCLAMEN EUROIVEUM. 59

the day so long as she kept moving about ; but in the evening, as soon as she sat down, and especially after she had gone to bed, she was greatly annoyed by a troublesome itching of the vulva, compelling rubbing, and a bearing down, necessi- tating counter pressure with the hand. The mucous surface felt raw, and there was said to be an eruption of some kind inside of the vulva. Cured by twelve powders of cyclamen30. (Dr. H. Ring.)

RESPIRATORY GROUP.

The symptoms of this group show that this drug possesses some power over the thoracic ganglia. Our provers report : Hacking cough ; oppression of the chest with difficulty of respiration ; in the evening his chest feels weak, as if he had not strength enough to draw a long breath ; painful pressure iu the left side of the chest, especially around the heart, as though too much blood had accumu- lated in this region, with perceptible palpitation of the heart ; when sitting still, he feels a lancing pressure on the chest, in the upper arm and tibia ; tearing stitches in the chest, during motion and rest, with dyspncea and shortness of breath.

These symptoms denote an irritation of the thoracic ganglia of a rheumatic nature ; they will most probably be found accompanied by other sigtis of abnormal action in the chylo-poietic or cerebro- spinal range. In examining tbe whole series of symptoms which have been recorded of this drug, we shall find that the various pains which our provers experienced in the region of the spinal cord and in the extremities, reflect a rheumatic type of the neuralgic order. We read, stitching pains in the left side of the back ; drawing pains down the spine, relieved by moving the shoulders backward ; laming pres- sure in the whole arm, as if in the periosteum, and deep in the muscles ; slow bending of the right thumb and index-finger, tiieir tips have to be straightened by main force ; crampy pains in the back part of the thigh ; stitching pains in the muscles of the right calf ; pains as if sprained in the foot, passing off by contact and when walking.

Other symptoms denoting a peculiar irritation of the nervous filaments interwoven in the dermoid tissue, and reported by reliable provers such as Franz and Langhammcr, are the follow- ing : Violent itching succeeded by warmth or a feeling of numb- ness ; itching on the big toe, compelling one to scratch, after which white blotches show themselves, itching still more ; bright-red spots on both thighs, as if the skin had been burnt. The itching which this drug causes is peculiar; it is intensely annoying, felt in various; parts of the body, stinging and burning after scratching.

Drawing and tearing pains, with pressure, felt especially in parts where the

60 DIGITALIS PUEPUEEA.

bones are immediately coverel by the integuments, are likewise a characteristic symptom of the action of this drug.

To these effects of the drug we may add a feeling of languor, debility, restless sleep and febrile conditions, such as chilliness or shuddering of the whole body ; heat of one part of the body while others feel cool and chilly.

Cyclamen is one of the many drugs in our materia medica of a limited range of action, and where it is therefore all the more neces- sary to have an integral view of its therapeutic range which is fortunately clearly defined, beyond the possibility, as it would seem, of baseless speculation or skepticism. The drug may be prominently indicated by single groups of the series, by the condition of the res- piratory apparatus, of the chylo-poietic organs, or of the sexual system ; as a general rule we shall be able to trace the pathological disorders for which this drug is especially adapted, to the more immediate influence of atmospheric miasms, and to the constitutional receptivity of the individual as conditions of their disturbing action upon particular functions and organs.