Hydrocyanicum Acidum

CONGESTIVE HEADACHE— These symptoms indicate hydro- cyanic acid in congestive headaches of a peculiar character. The headache may be preceded by dizziness resembling intoxication. The patient complains of a dull, heavy pain which may be seated in the forepart of the head, involving the sight which is obscured, or it may first be felt in the occiput, whence the pain may extend to the forehead ; or the pain may be felt in various parts of the head. It is accompanied by extreme prostration, slowness of the pulse ; there may be oppression of breathing and a feeling of embarrassment or weight in the region of the heart ; the patient may likewise complain of feeling cold with shivering.

It is very probable that in vertigo which occurs par- oxysmally, with unequal and slow pulse during the attack, and perhaps some irritation about the stomach, nausea and pain, obscu- ration of sight, this drug may be useful. Almost every one of Jcerg's provers experienced a feeling of dizziness as if he had been intoxicated. Hydrocyanic acid is particularly indicated, if there is danger that these paroxysms of vertigo may be the precursors of epileptic spasms.

The cases of poisoning given you, make a further enumeration of symptoms unnecessary. Of course, the attack comes on suddenly, and may be preceded by a sensation as of a shock in the brain. The stage of unconsciousness lasts long, is very profound and is further marked by lockjaw, frothing at the mouth, rigidity of the limbs, spasms extending from below upward, contortions of the face, invol- untary discharge of stool and urine ; emprosthotonos.

A number of interesting cures of this disease are reported in Frank? s Magazine. The dose employed is rather large, but the cures are none the less cures, and may encourage other physicians to try hydrocyanic acid in this distressing malady.

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CATALEPTIC SPASMS may yield to prussic acid.

A middle-aged lady was suffering with the chronic consequences of acute carditis, for which she took the acid in ordinary doses. The acid caused great muscular debility, especially on the left side, which culminated in a sort of cataleptic spasm, during which she lay motionless and speechless, without a sign of life, with scarcely perceptible respiration, but with the pulse easier, fuller and more regular The spasm lasted for several hours, when the power of speech and motion returned. She asserted that she had been fully conscious all this time, and that she had heard and noticed everything. The spasm terminated in profuse perspiration and was followed by recovery.

APOPLEXY. — Hydrocyanic acid may manifest curative virtues in apoplexy, although this attack differs from the paroxysms caused by hydrocyanic acid in this, that after the return of consciousness in a case of poisoning by this acid, the nervous energies generally become fully restored, without a trace of paralytic weakness being left behind, whereas in apoplexy, the limbs remain either partially or totally paralyzed after consciousness is restored. Nevertheless, Sandras shows that hydrocyanic acid produces all the essential pre- cursory symptoms of apoplexy, viz., formication, pricking in the extremities, vertigo, buzzing in the ears, drowsiness, excessive weak- ness, etc.

PULMONARY APOPLEXY— Speaking of apoplexy, we may as well mention in this place that prussic acid may prove curative in some forms of pulmonary apoplexy for we find the lungs gorged with a blackish, fluid blood, and the respiration is altered as it is in apoplexy of the lungs, short, gasping, unequal inspirations, in cases where death took place suddenly, as by a stroke of lightning. This recommendation, however, is purely theoretical ; I am not aware of a single case of this disease where prussic acid has been exhibited with success.

TETANIC SPASMS. — Hydrocyanic acid causes, and may there- fore cure, tetanic spasms, with lockjaw, bloating of the face and neck, protrusion and glistening of the eyes, immobility and dilatation of the pupils, bluish-red color of the face, collapse of pulse, rigidity of the limbs ; the trunk is either bent forward or backward. These convulsions are accompanied by, and in a measure depend upon, a congested condition of the cerebral vessels.

78 ACIDUM HYDROCYANICUM.

The patient, a lady of twenty-three years, had been ill a long time, the attacks lasting as long as nine months, and had endured a severe surgical operation, under the supposition that she was laboring under pressure upon the brain from exostosis under the right frontal protuberance. The doctor at last found her lying in an appar- ently unconscious state, the limbs and jaws rigid, the forearms bent on the arms, which were pressed firmly against the sides ; the eyes fixed and drawn somewhat up- ward and to the right ; the eyeballs slightly sensitive to touch ; a constant succession of tears were rolling down the cheeks ; the beats of the heart were very irregular and feeble.

She would occasionally utter a groan or sigh, and press her hand forcibly over the region of the heart, as if suffering pain there: at these times the limbs would become more relaxed, and she would frequently raise herself in bed and gaze vacantly about the room for a minute ; then, if not restrained, she would throw her- self forcibly upon the pillow again, or fling herself from one side of the bed to the other. Her husband was frequently obliged to exercise great force to prevent her from injuring herself; if any means were used to extend the contracted arms, or to open the clenched teeth, she would exert greater force to prevent it.

This lasted some twenty-four hours, and then tonic contractions ceased. She now became very busy in packing and folding her bed-clothes, and placing them under her head or elsewhere about the bed, at the same time guarding them with watchful eyes, allow- no one to touch or take them. If this were attempted, she would strike with her full strength. She seemed to notice no person in the room, unless they interfered with her plans, but if any one entered the door, she would seize a pillow or anything within reach, and throw it forcibly at the intruder.

At other times she would fix her eyes on a particular spot on the wall, or on a picture, or follow an imaginary figure or object with her eyes, as if watching its motions. She was frequently talking, laugh- ing loudly, or scolding vehemently ; she would imagine herself surrounded by many friends, shaking hands with them, and calling them by name, as they appeared before her. She asked no questions and would return no answers. During this time, which lasted four days before relief was given, she took no nourishment voluntarily, and only such as could be put into her mouth, after forcibly prying open the clenched teeth. * * * The pressing of the hand over the heart, and the repeated groans while doing so, led me to think she was suffering sharp pains, probably of a stitching character, in that locality.

The irregularity and feebleness of the heart's action, drew my attention to hydrocyanic acid, which was given in the thirtieth potency with the most favorable results.

SPECIAL SENSES.

The alteration of sight which this acid causes, is of a sympathetic character, depending upon a primary irritation of the brain which it is necessary to consider, if the ophthalmic weakness, such as dimness of sight, with abnormal dilatation or contraction of the pupils, is to be cured.

CHYLO-POIETIC GROUP.

Some of Joerg's provers have recorded a few characteristic symp- toms in this direction.

All experienced a scraping at the root of the tongue and in the throat, followed in one case by a sensation of foul air at the root of the nose, and by pricking.

Another prover experienced a sensation as of a lump in the stomach. After eating some bread and butter, he complained of malaise, heartburn, water-brash, followed by an increase of hunger, in

ACIDUM HYDKOCYANICUM. 7(.)

spite of which he felt an aversion to food ; violent hiccough troubled him afterward, accompanied with a disposition to heat and sweat.

One prover, who took two drops of Ittner's acid, experienced a scraping in the larynx, which the other provers likewise complained of, with secretion of mucus, tightness and pain in the chest. The symptoms in the throat and chest suddenly disappeared, and were succeeded by rumbling in the bowels, followed by pain in the right kidney, thence shifting to the stomach and spreading all over the bowels, without any urging to stool, with a more copious discharge of cloudy urine, general malaise, cold shiverings, occasional return of the pain in the head, drowsiness, weariness, diminished frequency of the pulse.

In view of this specific relation of hydrocyanic .acid to the nerves •of the stomach, it is not astonishing that this agent should have manifested remarkable curative powers in

CARDIALGIA, characterized by a crampy or gnawing pain in the pit of the stomach.

In the cardialgia of pregnant women, with a burning distress in the epigastrium, extreme sensitiveness of this region to contact, ex- haustion in consequence of the pain and vomiting, prussic acid has •done eminent service. If the dilutions remain inoperative, two or three drops of the medicinal acid may have to be administered three times a day.

Kopp relates the following interesting and instructive cure. A man of forty-four years had been suffering for two years and a half with the following symptoms : Con- fluence of saliva in the mouth, frequent spitting up of a frothy saliva, especially in the morning ; painful drawing from the pit of the stomach toward the back, especially the left side, frequently accompanied by spasmodic constriction ; a pressure was felt in the abdomen, extending to the chest and more particularly to the left scapula.

In the forenoon, and sometimes at night, he felt a cutting, spasmodic distress proceeding from the lower part of the chest to the stomach and back ; he complained of flatu- lence, nausea, vomiting of phlegm, a watery fluid and bile. He had no appetite and was costive. Oppression on the chest without cough, with a feeling of repletion and . malaise in the abdomen. Occasional attacks of vertigo, ill-humor, irritable temper.

He felt languid, exhausted, grew thin and looked sallow. For two years he had been trying every possible remedy, without the least success. He then was put on the use of ten drops of Vauquelin's acid in six ounces of cherry-water, of which he took a table-spoonful every two hours, continuing h s preparation with occasional intervals for ten weeks, during which period he took in all three hundred drops. His recovery was perfect; his fretful and irritable temper was likewise entirely changed.

80 ACIDUM HYDROCYANICUM.

manner ; in a few hours, to the astonishment of herself and friends, she was apparently quite well, and has since had no return of her complaint." To this report Pereira adds, "It can hardly be im- agined that irritation of the stomach can be rapidly removed by a substance which is itself an irritant." If Pereira had had the remotest idea of the homoeopathic law of cure, he would have had no difficulty in comprehending, that irritation of the stomach can only be removed by a substance which is itself an irritant.

UNEASINESS IN THE STOMACH— Pereira mentions an- other case of uneasiness in the stomach, for which the patient gradually took the enormous dose of two drachms of the acid pre- pared according to the Dublin Pharmacopoeia. He was seized with tetanic convulsions, but his life was saved, and the complaint had left him entirely after recovery. If prussic acid was the remedy in this case, the probability is that the attenuated acid would have done what drop-doses of the original acid were unable to accomplish.

Joerg's provers have shown that hydrocyanic acid may powerfully and painfully affect the bowels.

A delicate, sensitive lady was attacked with violent cramp-pains in the bowels depending upon irregularities in the portal system ; the pain involved the rectum, causing retention of stool. Every means of relief remained fruitless, except hydrocy- anic acid which helped in a few hours.

INVOLUNTARY EVACUATIONS from the bowels are char

ACIDUM IIYDROCYANICUM. 8 L

acteristic of prussic acid and when this symptom occurs as one of a larger group of symptoms, especially in connection with lesions of the brain, spinal cord or nervous system, we should bear in mind this acid, as possibly curative in the case. In the case of this rem- edy the involuntary evacuations are due to paralysis of the sphincter ani. The following symptom has been considered as a valuable in- dication : Drinks roll audibly into the stomach and intestines, making a gurgling noise. This latter symptom is at times present in DIARRHOEA AND DYSENTERY and may call for the exhibi- tion of hydrocyanic acid.

, ENGLISH CHOLERA. — Pereira commends this acid in English cholera ; he says that he has often seen it cure severe forms of this disease after opium had failed.

Our provings do not point to hydrocyanic acid as a remedy for cholera. This agent may cause vomiting and cramp-pain in the bowels, but, in the case of Joerg's provers, this pain was not asso- ciated with any urging to stool. On the contrary, the tendency of hydrocyanic acid seems to be to limit the alvine secretions ; if diar- rhoea does occur as one of the effects of this agent, it is most proba- bly in consequence of some peculiar idiosyncrasy in the patient's constitution. In Pereira's cases, the acid was probably used upon the principle of palliative antagonism.

ASIATIC CHOLERA. — Homoeopathic physicians have used this agent in Asiatic cholera in the very last stage, when the patient seemed threatened with death from asphyxia, with excessive or- thopnoea, apoplectic conditions of the brain ; the patient is cold ; vomiting, diarrhoea and cramps have ceased ; innervation seems universally threatened with annihilation.

Our provings show that the acid has a tendency to increase the secretion of urine during the period of organic reaction. A watery urine was secreted by most of Joerg's provers in increased quantity some time after the cerebral and respiratory functions had been

vol. i. — 5>

82 ACIDUM IIYDROCYANICUM.

affected by the acid. This symptom seems to indicate its use in spasmodic paroxysms, provided the other symptoms correspond.

PARALYTIC RETENTION OF URINE— The primary effect of the acid indicates its use in paralytic retention of urine, with which old people are sometimes afflicted.

CATARRH OF THE BLADDER— In one prover, the acid caused an increased flow of urine with burning in the urethra. This symptom may lead us to think of the acid in catarrh of the bladder, provided the constitutional symptoms correspond.

SEXUAL GROUP.

In a case of poisoning by hydrocyanic acid the scrotum was found blue, and partially deprived of the epidermis ; the penis was in a state of semi-erection, and there seemed to have been a discharge of seminal or prostatic fluid.

The acid seems to be possessed of some power to affect the sexual nervous system. Hence it has been advantageously employed in spasmodic affections of the female organs.

An unmarried lady who was attacked with the most agonizing cramps previous to the appearance of the catamenia, was radically cured by hydrocyanic acid, after having used every known anti- spasmodic remedy for eighteen months without the least benefit. In this case, the cure must have been effected in virtue of the law "similia similibus." Hydrocyanic acid may produce venous con- gestion of the uterus, with the violent cramp-pains, such as existed in this case.

AFTER-PAINS. — In view of this mode of reasoning, it cannot appear strange that this acid should have proved an efficient remedy for violent after-pains, as may appear from the following case, which we have extracted from Franks Magazihe:

THORACIC GROUP.

One of Joerg's provers experienced this symptom : " Scraping at the root of the tongue and in the throat, followed by sensation of foul air at the root of the nose, and prickling sensation."

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CHRONIC CATARRH.— This symptom may indicate the use of hydrocyanic acid in chronic catarrh of the nose, with foul smell, stinging high up in the nose, discharge of disorganized, greenish, brown-looking fetid pieces of hardened mucus.

Jcerg's provers uniformly complained of a scrajung sensation in the throat, followed by secretion of mucus in the bronchia.

From two drops, Otto experienced a scraping in the throat, with prickling down the larynx, hacking cough as from little hairs in the throat.

Another prover experienced a tickling and scraping in the larynx, with hacking cough.

In the formidable proving of the French physician, which I related above, hydrocyanic acid developed symptoms of an inflam- matory bronchial catarrh, with expectoration of yellow mucus and oppression of breathing.

Guided by these indications, we feel justified in recommending hydrocyanic acid in.

CHRONIC BRONCHIAL CATARRH, with tickling, scraping and prickling in the larynx and bronchial tubes, with expectoration of yellowish or whitish mucus, chilly creepings followed by fever, prostration. In

CATARRHUS SENILIS, with rattling breathing, paralytic oppression on the chest, sinking pulse, shiverings, excessive prostra- tion, hydrocyanic acid may do good service. In.

PHTHISIS PULMONALIS.— This acid has been recommended by many old school practitioners as a remedy for phthisis pulmon- alis ; others, on the contrary, reject it as a dangerous and mischiev- ous drug in this disease.

84 ACIDUM HYDROCYANTOUM.

Joerg's provers have recorded the following effects of the acid upon the lungs : Constriction across the chest ; shooting stitches in the region of the fifth and sixth rib near the sternum ; tightness of the chest, with stitches when taking a long breath ; pressure and tightness in the chest ; aching pain in both sides of the chest, chang- ing to stitching ; labored and deep breathing.

These symptoms certainly point to congestions of the pulmonary parenchyma, and may justify the use of prussic acid in the prelimi- nary stages of tubercular phthisis, where these congestions occur. There is no reason why this agent should not do good in ulcerative processes which spring from such a pathological basis. Harless considers prussic acid, if given in tolerably large doses, a most unre- liable and even hurtful drug in cases of fully developed catarrhal and tubercular phthisis, with profuse suppuration, hectic fever, colliqua- tive sweats, prostration ; he thinks that it only palliates these symp- toms for a while, and afterward hastens the fatal termination of the disease. If the acid is at all indicated in phthisis, it should be given in the higher attenuations ; they have no such effect as Harless describes.

One of Joerg's provers has recorded this symptom : " Sensation as if the larynx were more spacious, with a scraping feeling." We have met with this symptom in

LARYNGEAL PHTHISIS, where hydrocyanic acid may be of service in every stage of the disease.

ASTHMA. — Prussic acid has moderate attacks of spasmodic asthma, with suffocative paroxysms.

ANGINA PECTORIS. — If the paroxysms seem to depend upon the existence of organic disease of the heart, prussic acid may afford either partial or permanent relief.

HEART DISEASE. —In incurable heart disease it may palliate the agonizing oppression, fainting spells and violent palpitation which are often present in organic disorders of the heart.

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FEVER GROUP.

This case, and the provings instituted by Jcerg and others, show that the fevers to which hydrocyanic acid is homoeopathic, partake of the character of ataxia,

NERVOUS FEVERS, the principal feature of which constitutes debility, deficiency of animal temperature ; states of

DEBILITY rather than fever ; or

HECTIC FEVERS, with tendency to sudden and exhausting flashes of heat, followed by perspiration. In phthisis, if these hectic symptoms become exceedingly troublesome, prussic acid may act as a good palliative.

* MENTAL GROUP.

HYSTERIA, HYPOCHONDRIASIS— The symptoms of mental derangement which hydrocyanic acid causes, seem to me worthy of note only in so far as they belong to some other superior derange- ment, such as hysteria, hypochondriasis ; it may cause dullness of mind, irritability of temper, a gloomy mood, gay delirium. The following case shows that it may prove useful in cerebral hysteria, with derangement of the mental faculties :

86 ACIDUM HYDROCYANICUM.

repeating the dose she was attacked with merry delirium ; although naturally of a timid and quiet disposition, the effects of the acid induced a contrary state, singing and warbling, jumping about in the room with a stick in her hand ; she felt like a person intoxicated, her pulse was very much accelerated. This state lasted three days, although the medicine was discontinued. ,

Bitter almonds contain hydrocyanic or prussic acid, and cases are

on record where they have produced very serious, and even fatal

the following interesting case of poisoning, taken from the Medical

Times and Gazette:

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The most noticeable feature in this case was the frequent rallying after the act of vomiting, with the speedy relapses; these were evidently due to the formation of fresh hydrocyanic acid. * *

On being questioned, the mother said the child had given a cry when the symptoms commenced, but it is difficult to determine from her account, whether it was the characteristic cry or not.

In Jcerg's provings we find experiments made with "aqua amygdalarum amarum," obtained from the bitter almond by distil- lation The doses taken by the different provers ranged from five to fifty drops. The most prominent symptoms produced were : a marked depression of the pulse, a feeling of half-intoxication, dull heavy pain in the head, lassitude, a desire to sleep ; irritation of the larynx, followed by hawking up of mucus, and a well marked hoarseness. We have also, darting, stitching and shifting pains in the chest, below the left nipple, causing somewhat difficult, painful breathing.

ANTIDOTAL TREATMENT In a case of poisoning, ammonia,

Pereira has great faith in artificial respiration. He once recovered