Drugs


Homeopathic Drugs camphor, Arsenic album.,Hydrocyanic Acid, Veratrum Alb.,Ipecacuanha and Nux Vomica indicated in different stages of cholera….


If I were asked: Which are the drugs that may be expected to act similar to Camphor in the first stage of spasmodic cholera? My answer would be: Hydrocyanic Acid, and next to it: Arsenic. I shall not trouble you, by reading to you a number of cases of poisoning by the acid named. You will find them recorded in the 4th and 10th volume of Allen’s Encyclopaedia. Sudden falling down with loss of consciousness owing to excitation of the cerebral sympathetic, with its consequent sudden withdrawal or shutting out of arterial blood from the brain, is, in all cases of poisoning, worthy of the name, the first effect of the drug’s action; then follow epileptic convulsions, spasmodic breathing and tetanic cramps; on the whole a second edition of what you have learnt now to recognise as Camphor poisoning or spasmodic cholera. As the acid is by far more virulent than Camphor (one grain being sufficient to kill an adult, while 160 grains of Camphor, would set up alarming symptoms for a time, but would allow the patient completely to recover) I shall give you one of Hydrocyanic Acid poisoning, which ended, as most such cases do, fatally. We shall have then the advantage to study the post mortem changes effected by the drug-changes we can hardly ascertain in the case of Camphor poisoning, as there is hardly a fatal case yet known.

A girl, aged 22 years, swallowed by mistake a dose of Prussic Acid, equivalent of a little less than a grain of pure poison. At the time when this was taken she was sitting in a chair; but she instantly jumped up, ran for a short distance holding up her arms and gasping, as it were, for breath; she then fell, became insensible and was violently convulsed, the muscles of her face undergoing great distortion, her limbs becoming spasmodically extended and her head drawn down upon her shoulders. In this state she was removed to her bed and was seen directly afterwards by Dr. Watson, who found her lying on her back, with the body drawn a little forward; the limbs fixed and extended in tetanic spasm: the whole face swollen, turgid and almost purple from congestion; the jaws clenched; the mouth covered with foam; the eyes half closed, but prominent and glistening, with their pupils widely dilated, and quite insensible to the stimulus of light. She was breathing slowly, with deep prolonged inspirations, and uttering a low, moaning noise. The pulse at her wrists could not be felt, although the heart still continued to beat with a feeble fluttering effort…. The breathing became slower and deep prolonged inspirations, and uttering a low, moaning noise. The pulse at her wrists could not be felt, although the heart still continued to beat with a feeble fluttering effort… The breathing became slower and slower, the limbs at this time remaining fixed and immovable; and she died in from fifteen to twenty minutes after the ingestion of the poison. The post-mortem appearance in this case was as usual in cases of poisoning by Hydrocyanic Acid. The cerebral vessels, both upon the surface and in the substance of the brain were full of black, fluid blood; the lungs highly congested, but free tubercle or other disease; and the cavities of the heart full of black, uncoagulated blood.

Spasmodic respiration is noted by all observers of acute poisoning. Boehm pointed out that it is to expiratory stage that this character especially belongs. According to Dr. Wood, the chronic effects of the vapor are: difficult respiration, constriction of throat, and feeling of suffocation.

If you remember the description of Niemayer, as quoted in the first of these lectures, of the appearance of the blood after death of cholera victims, then you will find in the haematic effects of Hydroc. Acid an additional similarity to spasmodic resemblance between the two.

Dr. Russell, I believe, was the first who applied it in cholera. Hydrocyanic Acid, he says, we have seen give at least temporary relief in a few cases, where there was great prostration and oppression of the chest. One poor woman, a sober respectable person, who had been ill for twelve hours when we saw her, and complained much of excessive uneasiness at the heart exclaimed after a few doses of Hydrocyanic Acid, `God be thanked, my breast is getting benefit’ and for some time there was decided improvement both in her sensations and appearance. On the whole, however, we believe that the number of cases in which it is indicated, will not be found large; perhaps the particular period suited for its administration is very short.

I need not tell you that Hydrocyanic Acid has never ceased from the time of Dr. Russell, that is from the year 1848, to be one of our stock remedies in the state of cholera collapse.

Some years ago I took occasion to address a letter on the subject to one of the Calcutta daily papers; and although the letter dates as far back as 1876, I believe it may still be of sufficient interest to you. It runs as follows:

(TO THE EDITOR OF `THE ENGLISHMAN.)

SIR,-The last issue of the Englishman’s Saturday Evening Journal contains an article headed The Month: Science and Arts, in which it is stated that Surgeon-Major A.R. Hall, of the Army Medical Department, had lately introduced a new method of treating cholera patients in the cold stage, or collapse. Surgeon-Major Hall had himself an attack of cholera, during which he observed, while his skin was blue and cold, and when he could not feel the pulse at his wrist, that his heart was beating more forcibly than usual. He, therefore, concluded that the want of pulse at the wrist could not depend upon want of the power in the heart; and after a reference to the works of the distinguished physiologist Dr. Brown-Sequard, he came to the conclusion that the heart and all the arteries in the body are in a state of spasmodic contraction. The muscular walls of the heart, therefore, work violently, and squeeze the cavities, so that the whole organ is smaller than it ought to be; but it cannot dilate as usual, and so cannot receive much blood to pump to the wrist. Surgeon-Major Hall believes, consequently, that the nervous system wants soothing, instead of stimulating, and recommends sedatives in the state of collapse, in the place of stimulants, hitherto used, and concerning which experience has shown that they do more harm than good. This method of treatment was applied in twenty cases where the patients were either in collapse, or approaching it, and eighteen of these recovered. They were natives of Bengal. Surgeon-Major Hall recommends in severe cases, among Europeans, the employment of Prussic Acid, Calabar Bean, and other true sedatives. The article closes with the following words: It is to be hoped that this sedative treatment may have an extended trial, and that before long, we may have further favourable reports concerning it.

Now, is it not strange that writers on medical subjects should ignore the existence of a school of medicine which has, since 1932, the first time cholera made its appearance in Europe, all along protested against the use of stimulants, and insisted, moreover, upon treating cholera patients with medicines which act anti-spasmodically? I need hardly say that it is the homoeopathic school of medicine to which allusion is made here. The sedative treatment of cholera has had an extended trial, indeed, and the reports concerning it have been favourable to such an extent that cholera may fairly be considered as the pioneer of homoeopathy all over the world. Yet we are now recommended to hope and to try!

Surgeon-Major Hall recommends, amongst other true sedatives, the employment of Chloral Hydrate, Prussic Acid, Calabar Bean, and Bromide of Potassium. Out of these four drugs, Prussic Acid is the most powerful, and it is this drug which amongst others, homoeopathy have now tried for the last forty years.

This is not the place to discuss the modus operandi of sedatives in cholera. Surgeon-Major Hall, inspite of his large and varied experience of cholera at the sick-bed, during a sojourn of 12 years in Bengal, had not come to learn the true nature of the action of cholera poison till he felt its effects upon himself. It remains now for him, and for his school of medicine, to enlighten themselves in a similar way about the true nature of the action of what they call sedatives! Nothing short of a most careful and minute proving of those so-called sedatives on themselves, when in a state of health, can elicit the true action of these drugs. This is the way in which homoeopaths have gone to work; and, when our learned brethren of the allopathic school will have done the same, then, and not before, will it be time to discuss with them the modus operandi of drugs as therapeutic agents.

July 30, 1876.

You see here, gentlemen, the way in which our noble friends of the allopathic school appropriate to themselves our valuable remedies under a false name and a false pretence. To them, Hydrocyanic Acid is a sedative, because they know it to be capable of checking spasms; as to its toxicological action on the healthy, they do not know, or do not care to know. To them, Chloral Hydrate, Prussic Acid, Calabar Bean and Bromide of Potassium, are, each and all of them, neither more or less than sedatives. The wonder only is, why Surgeon Major Hall did not derive as much benefit from Chloral Hydrate, a sedative par excellence, and a true and undoubted physiological sedative besides.

Leopold Salzer
Leopold Salzer, MD, lived in Calcutta, India. Author of Lectures on Cholera and Its Homeopathic Treatment (1883)