To this may be added the following quotation from Wibmer’s Toxicology :-
Small doses of Cuprum Aceticum, if continued for a length of time, may finally destroy life by emesis, catharsis, 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.(* This is no doubt the general rule and therefore I have said that the alvine discharges occurring under the toxic influence are not choleraic. That exceptionally they may, however, be wanting in the signs of increased bile secretion, and approach, moreover, to all appearance, choleraic evacuations, the previous case has shown in one of the subjects poisoned.*)Besides these signs of local irritations, many symptoms are frequently apparent which denote absorption of the poison and show its action upon distant organs…. The headache, occasional delirium, deafness, tetanic convulsions, lock-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, 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 abdomen which is sensitive to pressure, diarrhoea with discharge of brownish, greenish, blackish and even bloody excrements; occasionally, 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.
Taking into consideration all you have now heard about the peculiarities of the Cuprum action, you will, I hope, see that this drug is not analogous in its toxic effects to Camphor, or, at any rate, that the analogy between them is too remote, as to allow them to be considered as interchangeable quantities. Cuprum, as a homoeopathic remedy in spasmodic cholera, is only indicated after vomiting and purging have set in: there must be some decided irritation of the alimentary mucous membrane, before we can ever think of making use of that drug in cholera. In other words, its function actually begins there where the function of Camphor ends. But even after purging and vomiting have set in, you must not rely too much upon Cuprum to arrest them, knowing as you do, that there is but little similarity between choleraic evacuations and such evacuations as generally occur under the toxic influence of the drug so often mentioned; nor can you reasonably expect, that it shall subdue general arterial spasms, and the algidity and cyanosis dependent upon them, since it has no direct action on the article system. Camphor, Hydrocyanic Acid, or Arsenic will do that far better, even after the evacuation period has set in, provided the discharges are yet scanty, and the principal danger is still threatening from the side of the contracted arteries. All Cuprum can reasonably be expected to do is to check the cramps of the extremities, occurring or increasing during the evacuation period, in as much as these cramps originate from, or are intensified by, the irritation set up in the digestive canal. This is certainly not much. For after all those cramps are only partly owing to irritation of the alimentary canal. We must not forget that the loss of water by the cholera discharges, forms another element of nerve-irritation; the anaemia produces by impoverishment of the blood, may again be another important element of nerve- irritation; and with regard to both these factors Cuprum must be pronounced impotent on homoeopathic principle, at least as far as its direct influence is concerned. Indirectly, however, it can hardly be denied, that Cuprum is capable of exerting a calming influence on nerve irritation, as far as the same caused by desiccation. For it is not so much the loss of water which causes desiccation of nerve tissue, but the incapacity of the gastric mucous membrane of absorbing and assimilating outward supplies in the shape of drink, and thereby eventually compensating for the loss of the liquid portion of the blood. Now this incapacity is entirely owing to extreme gastric irritation; and the same being purely nervous, non-inflammatory, should certainly find in Cuprum a far greater simile than in Arsenic. Arsenic may, or may not affect, the gastric mucous membrane; but whenever it does so, it is irritation tending towards inflammation which is set up, while under the influence of Cuprum, a purely nervous irritation is often produced. I am convinced we have in this respect often erred on the side of Arsenic. On the whole it would appear that there is hardly any cause to consider Cuprum as anything more than a very useful auxiliary remedy in cholera, good for checking certain unpleasant symptoms, as gastric and nervous irritation, and some such spasm as are connected therewith, but far from checking the progress of the disease itself, be it in its spasmodic or non-spasmodic form.
We must, however, not undervalue the services of a remedy which is capable of subduing nervous irritation in cholera, and especially of subduing irritation of the solar and hypogastric plexus. The whole choleraic disorder seems to gravitate towards this network of the sympathetic nervous system. In whichever way the disease may make its first appearance, the solar plexus is soon made to feel the whole brunt of the attack. If we remember at the same time how quickly, comparatively speaking, patients recover from an attack of cholera, if they do recover at all-we can hardly avoid the conclusion that, extremely dangerous a disease as cholera no doubt is, it must after all be purely neurotic in its origin; and such being the case, or at least the conclusion, we cannot help assigning to the ganglia of the abdominal viscera the whole series of such haematic alternations as manifest themselves by vomiting, purging, total absence of bile-secretion, etc. Camphor could not succeed so well as it does, in arresting the progress of the first stage of spasmodic cholera from developing any further, were it not, that this drug has the same tendency, like the cholera poison itself, to assail, in the second instance, the solar plexus.
Collapse, it has been said, is the great final issue of cholera, where all varieties meet, in the case the disease is not checked in its course; with equal reason it may be said, that the solar plexus is the great highway through which all varieties pass, before they reach that final stage. And Cuprum that travels, pharmacodynamically, over the same ground, will therefore, and does therefore often check the further progress of the disease. It is true the sort of irritation set up in the before mentioned sympathetic ganglia of the abdominal viscera by Cuprum, is not exactly the same as that produced by cholera; otherwise the alvine discharges under the toxic influence of Cuprum would be choleric in their nature; but not in all cases is there required a perfect similarity between drug-action and disease, in order to effect a cure, far less an arrest of the progress of the disease; and in the evacuation period, before collapse has set in, such an eventual check of the further development of the morbid process, will often result, as it were, by itself, into restoration to health, provided there be still left sufficient recuperative power in the patient. By cure, in the proper sense of the word, I understand, the restoration to health of a man afflicted with a chronic disease; in such a case there is no seasonable trusting to the self-restoring power of nature; the very fact that the disorder has become chronic, and is as a rule gradually growing worse, shows how little we can expect from nature when left to her own resources. The stimulus towards improvement must here entirely come from outside. Otherwise is the case with regard to acute diseases during the stage of development. Such diseases, of which cholera is a fair specimen, get often well as it were, by themselves, without any outward impulse. Of the fifty per cent. of cholera patients who thus get better by themselves, there is only a small proportion who go the length of collapse; most of them get better before that stage is reached. There is then evidently a considerable amount of vis medicatrix nature still in full activity, at the evacuation period of cholera; the mere checking of the progress of the disease, means here restoration to health, as a matter of course, and under such conditions, we may fairly trust to a medicine that is somewhat deficient in similarity to the disease.
And after all, the case of poisoning cited before shows, that Cuprum is capable of producing cholera-like alvine discharges, exceptionally, it is true, yet such exceptions suffice to show, that there are conditions under which Cuprum comes very near in its toxic effects to the effects of cholera poison and of all such conditions, those prevailing during a cholera epidemic are certainly most effective in this respect.
