Cuprum Aceticum

[ACETATE of copper, verdigris.]

If the refuse of grapes, in the process of wine-making, is placed into heaps, acetous fermentation will soon take place. If sheets of metallic copper are exposed to the action of these acetous fumes, the sheets of metal become oxidized. By the action of the acid upon this oxide the acetate of copper is produced, containing two equiva- lents of peroxide of copper to one equivalent of acetic acid, with six of water. This salt is an exceedingly active, acrid poison.

The oxide of copper is formed on the surface of copper vessels carelessly cleansed or poorly protected by an insufficient coating of tin. When we take into consideration the fact that dishes and vessels of copper are not only used by brewers, bakers, confectioners, distillers and in the manufacture of soda-water, but that they are constantly used in

58 CUPHini ACET10U3I.

our kitchens, we are not surprised to find on record so large a number of cases of fatal poisoning with this article. In the manu- facture of cucumber pickles for the market much mischief is done by giving to the pickle a tempting, bright green color, which is pro- duced by boiling vinegar in copper vessels, thus permitting verdigris to form. Serious gastric difficulties and, at times, death are the result.

Test. — The presence of this salt can be detected by the addition of a few drops of liquid ammonia, which will produce a deep blue color if the solution contains copper.

A lady of sixty-seven years, her daughter, aged thirty-nine, and a servant-girl, twenty-two years old, partook of chicken-fricassee which had been cooked in a badly tinned copper saucepan. This took place on the first of February. In the evening and during the night, these three persons, and more particularly the delicately formed daughter, were attacked with ineffectual efforts to vomit, contrac- tion and dryness in the inner mouth, thirst, violent pains in the epigastrium, colic, followed by several watery, whitish stools.

These symptoms continued on the following morning ; the daughter was moreover attacked with uninterrupted anguish, convulsions, painful aud hard swelling of the abdominal walls said, frequent fainting turns. The mother had eructations which tasted of copper, violent; colic with tenesmus, followed by liquid, greenish stools.

The next day, the patients were found by the physician with the following symptoms : The mother complained of heat and dryness in the mouth and intestines ; a metallic, styptic taste in the mouth, painful feeling in the epigastrium, frequent attacks of colic, followed by frequent discharges of fluid stools, painful distention of the abdo- men, some anxiety, general prostration, palpitation of the heart (to which she was subject more or less), a feeble and somewhat irregular pulse. The servant girl, who was robust and vigorous, exhibited the same symptoms, except that her pulse was fuller, her colicky pains were more violent, and the liquid stools more frequent. The daughter had the same symptoms, and moreover eructations tasting- of copper, intense pains in the epigastrium and abdomen withouc diarrhoea, violent headache, fainting turns, cold sweats, and a con- tracted, small, somewhat irregular pulse. A strong decoction of charcoal with sugar soon restored them all.

In this case, the symptoms of gastro-enteritis and the nervous affection constitute the prominent features.

On the 21-st of May, 1754, a Parisian lady was poisoned, together with her four daughters, by a milk soup which had been cooked in a .saucepan of yellow copper. Two hours after eating the soup these five persons were attacked with intense pains in the region of the

CUPRUM ACETICUAT. 39

stomach which were speedily followed hy convulsions that seemed to involve more particularly the abdomen and the upper and lower extremities ; when thus attacked they uttered a horrible cry, a sort of howl, or a croaking resembling the croaking of toads. They rose in their beds with an irrisistible force, so that the strongest men were unable to keep them down. They were quite crazy, looked frightened and endeavored to escape ; their eyes glistened and seemed to start out of their sockets.

They stared and looked wild. These paroxysms came so frequently that they seemed to continue without any interruption. If one was attacked, the other persons, upon hearing the cries of their companion, were likewise attacked with rage. Thus they kept up a sort of reciprocal howling.

Two of these persons are even now in this sort of sympathetic state of suffer- ing, although they occupy entirely separate rooms. As soon as one feels the attack coming on, the other is likewise affected. The mother and youngest daughter are now almost well, except that the abdomen is still painful, hard and distended ; the stomach weak, they suffer continually with pain between the shoulders at the elbows, in the bends of the knees, etc., with a feeling of languor in all their limbs.

Their look is confused, but they are in full possession of their mental faculties, and their speech is easy and perfectly rational. jSevertheless, they are still liable to these paroxysms of howling, which always come unexpectedly ; they go out, however, and attend to their business.

It is evident, from the symptoms of this case, that the main attack of the poison was directed against some important ganglionic centre, most probably the solar plexus, and that the irritation was conveyed to the brain from this point. What is, moreover, remarkable, is the periodicity of the paroxysms, the fact that they set in unexpectedly, that they were accompanied by convulsions, and succeeded by pains in various and apparently unconnected parts of the body. These conditions frequently characterize epileptic attacks, for which cup- rum may, therefore, be considered a remedy.

In the following case of poisoning with the acetate of copper, the symptoms again betray a violent irritation of the stomach and intestines, where the primary invasion seems to strike the ganglionic centres, developing in its train inflammatory conditions which seem to indicate copper as in specific homoeopathic rapport with inflamma- tory enteralgia, a gastro-enteric condition complicated with violent nervous disorders, such as may occur in an attack of cholera. Here are the symptoms of the case :

A man of thirty years had swallowed a quarter of an 'ounce of verdigris for suicidal purposes. This caused vomiting of the con- tents of the stomach which had a greenish tinge. The patient com-

40 CUPRUM ACETICUJI.

plained of violent colic and frequent tenesmus ; the region of the stomach was exceedingly painful to the touch, the thirst intense. The pulse was small, rapid, spasmodic, the respiration was accel- erated. The features were not sunken, hut expressive of great pain ; temperature of the skin normal, without sweat. Gradually, violent cramps in the calves set in ; the big toes were spasmodically drawn toward the soles of the feet amid intense suffering.

At this stage- the white of ten eggs was given, together with a quantity of warm water and milk. The ensuing vomiting was kept up for a time by tickling the fauces, and the patient soon recovered.

CEREBRO-SPINAL GROUP.

Wibmer, in his Toxicology, thus sums up the remote or constitu- tional effects of the acetate of copper: "Small doses, if continued for a length of time, may finally destroy life by emesis, cartharsis, hectic fever : however, we do not always discover distinct traces of inflammation in the intestinal canal, but the signs of an increased secretion of bile are never wanting. Besides these signs of local irritation, many symptoms are frequently apparent which denote absorption of the poison, and show its action upon distant organs.

That the poison is absorbed by the liver is clearly shown by my experiments, which have revealed the existence of copper in the liver: this absorption likewise accounts for the increased secretion of bile, the bilious vomiting, the jaundice, etc. Absorption by other organs, such as the brain and spinal marrow, is less certain. Not all persons who have been poisoned with, copper, show symptoms of cerebral derangement; I have fed a dog for two months on the acetate of copper without any other but local symptoms becoming apparent during the lifetime of the animal ; after death, no traces of copper could be found anywhere except in the liver.

"On the other hand, the headache, occasional delirium, deafness, tetanic convulsions, look jaw, paralysis and other symptoms, seem to show that, in many cases at least, the acetate of copper acts upon the brain and still more upon the spinal marrow ; it is particularly after injecting the poison into the veins of animals that violent con- vulsions, insensibility and paralysis were produced."

A careful study of the action of copper upon the cerebro-spinal axis seems to show, that copper affects the ganglionic centres and the medulla oblongata, but does not act primarily upon the cere- brum in such a manner as to justify its employment in meningitis, hydrocephalus, typhus and other cerebral diseases, upon homoe- opathic principles. In the first case of poisoning which I have

CUPRUM ACETICUM.'. 41

related to you, the little girl remained conscious and rational to the last. Among persons who were poisoned by eating of sausages, those who were attacked with nervous symptoms, complained princi- pally of vertigo accompanied with a sort of soporous stupefaction. The vertigo caused them to stagger about until they were unable to stand and had to lie down. It was attended with heaviness in the head and headache.

These symptoms may characterize the stage of incubation of some acute eruptive disease, when they may, moreover, be accompanied by transitory paroxysms of convulsions. If we take symptomatic indi- cations for our guides, we may consider the acetate of copper calcu- lated to shorten or diminish the violence of these preliminary symp- toms. We should not forget, however, that in cases of poisoning with copper the nervous derangements develop themselves subse- quently to the signs of gastric irritation.

Convulsive movements were only observed in the case of a woman of forty-seven years ; she, too, had partaken of poisoned sausages. After violent pains in the region of the last dorsal vertebra, which was not sensitive to pressure, the pain suddenly darted through the left arm as far as the wrist ; the arm was several times jerked up and clown with great violence ; this jerking was followed by paralysis of the arm, Avhich lasted for several hours, but did not extinguish the sensibility of the part. Here we have a distinct indication that in

CHOEEA of the upper extremities, and more particularly, if the chorea only affects one side, comes in paroxysms, with neuralgic 25ain previous to, or during the attack, and subsequent paralysis of the affected limb, the acetate or oxyde of copper may prove of great service. The affection may be traced to an irritation at some point •of the spinal cord.

EPILEPSY. — Both the acetate and the ammoniacal sulphate 0/ copper have been used with distinguished effect in the treatment ol chorea and epilepsy ; the toxical effects of copper which I have* ■described to you account for the curative virtues which this agent must necessarily possess in the treatment of these diseases.

DEBILITY. — Another symptom complained of was a feeling oi excessive debility and languor, accompanied with a troublesome drawing and tension in the limbs, and very frequently with a feeling of shivering and coldness, although the skin did not feel cold when touched. This sensitiveness to changes of temperature remained for

42 cuprum: aceticum.

a long time ; in one case it was marked by regular chills, so that the affection resembled fever and ague. We may infer from these facts that, in nervous affections to which copper is homoeopathic, the presence of debility, coldness and sensitiveness to changes of temper- ature affords an additional indication for the use of this drug.

EMACIATION. — Another result was emaciation which lasted more or less for several months. In nervous affectious, this would likewise constitute an important therapeutic indication.

PARALYSIS. — These last-named conditions, debility, coldness,, emaciation, may possibly culminate in chronic or semi-acute paral- ysis, where copper may prove a necessary therapeutic agent.

Frank relates the case of a boy of fifteen years, who was paralyzed in the following- strange manner : The patient was able to move the head and neck-, but the dorsal muscles as far as the neck, were completely paralyzed; the upper and lower extrem- ities were completely immovable, swollen and insensible, the urine could only be voided by pressure being made upon the bladder ; the rectum was likewise paralyzed. This patient was completely restored within three months by the exclusive use of copper. It is not stated how long this disease had lasted, nor how it originated.

Iu paralysis of the train, when caused by a process of metasche- matismus, an irritation of the cerebral substance having been super- induced by the sudden retrocession of some acute eruption, or of some other disorder which required copper as its specific remedy, Schmid recommends the acetate as a lit means to restore the reactive power of the brain.

MANIA. — -We have seen that copper may cause fits of mania with howling, and a muttering and occasionally a furious delirium. I am of the opinion that these violent manifestations of abnormal mental action are traceable to some primary irritation of the ganglionic or spinal centres, whence the irritation is secondarily transmitted to the cerebral nerves.

Cuprum has likewise caused, and may, therefore, cure a state of mental derangement characterized by melancholy, anguish, and even, by craziness of a shy, artful, peevish character. In

HYSTERIA, characterized .by a melancholy state of mind, shy- ness, dread of company, debility, muscular tremblings, loathing of food, indifference, costiveness, sallow complexion, the acetate of cop- per may prove very useful.

ORBITAL AND AURICULAR GROUPS. .

Persons poisoned with this salt complained of blackness of sight, scintillations in the field of vision. The pupils were dilated, but perfectly sensitive to the light; only in three cases, where considers

CUPEUM ACETICUM. 43

bio congestions of the head were present, the pupils remained con- tracted for a few days.

These symptoms seem to he simply confirmatory of the irritation of the ganglionic centres which copper may occasion, and which, both by its own direct action and a reflex action from the brain, may disturb every function in the living organism.

Buzzing and ringing in the ears were occasioned in. several cases ; three persons remained affected with hardness of hearing for a long time ; in one case, a girl of twenty-two years, this hardness of hear- ing amounted to absolute deafness.

CHYLO-POIETIO GROUP.

Wibmer sums up the poisonous effects of the acetate of copper in the following paragraph: "In small doses of one, two or three grains each, this substancee does not cause any serious symptoms ; but larger doses of ten to fifteen grains very soon cause a violent pain in the stomach and bowels, loathing, constriction of the throat, bilious and metallic eructations, desire to vomit, retching, vomiting of bile, mucus, greenish and even bloody substances, distention of the abdomen, which is sensitive to. pressure, diarrhoea with discharge of brownish, greenish, blackish and even bloody excrements ; occa- sionally, constipation with tenesmus, thirst, fever, loss. of appetite, anxiety, jaundice, etc., in short, all the signs of a most violent inflammation of the digestive organs. After death, we observe in- flammation of the intestinal canal and even of neighboring organs, liver, spleen., etc. The mucous membrane of the stomach, which is generally covered with a greenish or bluish layer, appears inflamed, marked with sanguineous exudations, sometimes gangrenous, thick- ened, even perforated, especially in the stomach and rectum ; the peritoneum and omentum are sometimes found inflamed. The other viscera are generally healthy.

GASTEITIS. — It is, therefore, evident that the irritating action of copper upon the stomach and intestines may cause gastritis and gastro-enteritis ; how far these results may be regarded as thera- peutic indications in cases where the accompanying nervous symp- toms correspond with the action of copper, will have to be determined by farther clinical experience.

ENTEEALG-IA. — We have shown that copper may prove spe- cifically adapted to certain forms of enteralgia and gastro-enteralgia, dysphagia and to degenerations of the stomach, characterized by vomiting of food, emaciation, etc.

44 CUPEUM ACETICUM.

Persons poisoned with the salt usually sailer with catting, con- strictive pains in the abdomen, which is drawn toward the vertebral column ; they are usually remitting, accompanied with diarrhoea, but more frequently with obstinate constipation ; if the constipation continues, there are slight drawing pains in the umbilical region and in the groins. Sometimes there exists a well-marked

GASTRODYNIA, a seated burning pain in the epigastrium, aggravated by pressure, and either accompanied by vomiting or nausea without vomiting ; loss of appetite and considerable thirst.

CHRONIC VOMITING, depending upon gastric irritation, with retching followed by vomiting of a greenish substance, slight coating of the tongue, tenderness in the epigastrium, colicky pains in the bowels, especially around the umbilicus, obstinate constipation, etc., has been cured with this salt.

CHOLERA. — Many of the symptoms of copper point to cholera with great prostration and coldness of the body ; cramp in the calves and toes ; horrid colic ; suffocation and syncope.

A young soldier in Louisiana was brought into the regimental hospital with " con- gestive fever," simulating cholera ; there was a deathly feeling behind the ensiform cartilage, [this symptom is claimed to be a keynote to the remedy Ed.] ; the whole surface of the body, face and limbs was cyanotic in a high degree ; the features were pinched; the skin cold and inelastic; there were horrid cramps in the abdomen and limbs, with rice-watery vomiting and purging. Cuprum aceticum, 2d decimal, in repeated doses, dry, relieved these symptoms, leaving him weak, but without pain. {Am.

Jour, of Horn. Mat. Med., May, 1868.)

JAUNDICE As a remedy for jaundice copper may be deserving of attention. AVibmer has shown that copper is absorbed by the liver, and that jaundice may be one of the constitutional effects of copper. Orfila relates the case of a man of forty-four years who undertook to poison himself with four drachms of the acetate of copper.

He was attacked with jaundice, previous to which he vom- ited a green substance. The nausea and vomiting ceased after the jaundice had set in. His tongue had a grayish coating upon it. The month had a pappy, coppery taste.

Slight colicky pains, thirst, dark- red urine which deposited a yellowish sediment. He recovered.

EXANTHEMATIC GEOUP.

The petechise which copper develops seem to mark the last stage of dissolution of the vital fluids, and are probably valueless as thera- peutic indications.

SCARLATINA. — The use of cuprum aceticum in scarlatina is often followed with excellent results in cases where the rash is iu>t

CUPRUM ARSENIOSUM. 45

well developed and where disturbances of the brain arise, depending upon this partial suppression of the exanthem.

A boy, ten years of age, was confined to his bed with fever, flushed face, hot head, redness of the eyes and muttering delirium. Aconite and belladonna were given for thirty-six hours without benefit. As these remedies did not relieve him, I suspected the presence of some form of exanthem as the disturbing cause, and found that a sore spot on the scalp had been healed with spirits of turpentine. Prescribed cuprum ace ti cum.

On my next visit I found him entirely relieved, with a papulous eruption thickly covering his body. He was well in a day or two. (Dr. Thos.

Haughton, Ohio Med. and Surg. Reporter, September, 1869.)

Of cuprum aceticum or the acetate of copper, verdigris, we make a watery solution in the proportion of 5 to 95, and afterward alco- holic attenuations, first in the proportion of 20 to 80, and all subsequent ones in the proportion of 10 to 90.

CUPRUM ARSEiYIOSUM.

[arsenite of copper.]

This very poisonous article has not been used extensively, although it is a drug of more than ordinary power in certain conditions. Jahr barely mentions it. Provings made with it tend to establish a sphere of action somewhat analogous to the other salts of copper, with a particular adaptation to gastric and abdominal troubles of a very painful nature. Cramps in the bowels, distressing colics, brought on by exposure, and similar difficulties have been successfully treated with it.

It has been given with fine results in obstinate vomiting, and in the vomiting of pregnancy, combining, in the latter condition, much of the curative powers of arsenic and of copper.

The following are selected from cases reported by Dr. J. IL Marsden in the Hahnemannian Monthly of January, 1873.

A young girl performed some out-of-door labor, causing her to perspire freely. The day was damp and drizzling; and she took a severe cold. In the night she was seized with a most agonizing pain in the lower abdominal region. Two' or three days later her condition was as follows : The pains still continued, but were less severe.

There was an extremely tender spot in the left ovarian region ; her tongue was heavily coated (white), and she had that general appearance of wretchedness which is observed in patients long confined by severe illness. Prescribed arsenite of copper3, to be taken every two hours. On the next day the pain was gone, the tenderness scarcely perceptible, and the whole general appearance greatly improved. She made, under the occasional exhibition of the remedy, a rapid and complete recovery.

A young married lady, mother of one child, after some preliminary suffering, began to experience pain in the sacral region, accompanied by frequent urination, tenesmus of the rectum, with mucous discharges as in dysentery. These discharges were so constant that she was soon wearied out from her frequent risings, and was obliged to have a cloth placed under her to receive them, as they almost uninterruptedly flowed from the bowels. Colocynth was taken without any apparent benefit. She made a rapid recovery under the use of arsenite of copper.

46 CUPRUM METALLICUM.