But such cases are, as a matter of fact, rare; and it we are to restrict the therapeutic use of Camphor to them, and to them alone, then the greatest part of the therapeutic sphere of our drug would be left out in the dark: for Camphor is just as entitled to be homoeopathically used in cases attended with spasms at the very onset. That the remedy in such cases has moreover more than a mere theoretical pretension, is seen clearly enough from the success it has attained at the time of Hahnemann where just the spasmodic variety of cholera was prevalent. And this is not all. For a close enquiry into the pharmacodynamic action of the drug on the one hand, and into the cases where it has gained its undoubted therapeutic success on the other, unmistakably shows that with spasms the action of the drug begins and ends. It produces in moderate doses chill and depression, which means, it produces spasmodic contraction of the small arteries; and it produces in larger poisonous doses, as we have seen before, in addition to the just mentioned contraction of the muscular coat of the arteries, general spasms. Further than that, the action of Camphor, however, never goes. It is no blood poison, nor does it injuriously affect any organism in particular-the severest cases of poisoning ending in a comparatively speedy and complete recovery. With the exception of some infants, we have yet to learn that an adult ever died of Camphor poisoning, or that he ever was permanently of the poison. Amongst the cases of poisoning cited at the beginning of this lecture,(*See Taylor’s Treatise on Medical Jurisprudence.*) there is one case of a woman who for weeks afterwards suffered of difficult breathing; which was after all but a spasmodic affection. If any one desired me to define in a few words the action of Camphor, I could not express it better, than by saying: Camphor is nothing if not spasmodic.
Such being the case we are now able to define the therapeutic sphere of the drug in cholera, both positively and negatively; we are able to say, where it may be expected to be of use as a therapeutic agent, and where not. Of the rare cases of cholera sicca; or such others, where sudden chill and depression, without any cramps, usher in the second stage of vomiting and purging-I have already spoken. There remain then the other two great varieties of cholera, the spasmodic, and the non-spasmodic variety as described in previous lectures. And here Camphor is homoeopathically in the first stage of the first variety, and counter indicated in the second variety, that is to say, in that variety of cholera which takes its beginning from a relaxed state of the bowels.
Cholera in its spasmodic variety is of a purely neurotic origin; it consists in a morbid excitement of the vaso-motor and motor nerves. It is only after the organs of sanguification have been involved, that haematic symptoms make their appearance, in the form of a separation from the blood of its serous liquid, giving rise to the well-known choleric evacuations. Purely haematic symptoms may however, make their appearance from the very beginning in the form of cholera sicca, as was the case during the cholera epidemic of 1855. The patient turn icy cold and feel at the point of death before any symptoms of vomiting or diarrhoea set in. The face and limbs lose all appearance of life, the eyes droop, and the hands close, giving the sufferer the aspect of a corpse. Under such circumstances Lachesis or Cobra would certainly be by far preferable to Camphor. I myself have seen such cases, and Cobra (Naja Trip. 3x) had a prompt and permanent effect for the better. These evacuations which mark the second stage of the spasmodic cholera variety, may be owing, as I have shown before, either to the general spasmodic state of the arterial system, which brings on congestions and transudation of serum within the abdominal viscera; or to a specific haematic action of the cholera poison. But whatever may be the case, it is evident that Camphor loses ground, as a homoeopathically acting remedy, from the moment haematic symptoms set in, for the simple reason that the poisonous action on the solar plexus, but not an action similar to the cholera poison; it causes heat of the stomach and pain in the region of the solar plexus-probably due to congestion of those parts-yet, for all that, it does not go farther, it does not cause transudation of serum within the abdominal viscera; in fact, it does not reach the blood or the seat of sanguification directly, nor does it do so even indirectly via the nervous system.
Again in the usual, non-spasmodic variety, where the disorder starts with a relaxed state of the bowels, gradually running on to choleraic stools, Camphor is from the very beginning out of place. More than in the second stage of the spasmodic variety of the disease, we want here particularly at the very outset a drug which by its physiological action on the healthy, has shown special destructive affinity to the intestinal mucous membrane; and of all the drugs known in this respect, Camphor would be, and is the last. The time occupied in such cases with the administration of Camphor is so much precious time lost to the patient; and we have already come to know, how precious time is especially in cholera cases. Counter-indication is here almost as valuable, as positive therapeutic advice. Let me therefore emphatically impress upon your mind, that whenever not have good reason to believe, from the history of the case, that the disorder originated with the digestive organs, yet are wasting your time with Camphor.
If we remember now, that the spasmodic variety of cholera, prevalent as it was at the time of Hahnemann, has become rather rare since; that the usual type of cholera now-a-days is, as a rule, preceded, as already described before, by malaise, general depression, disordered assimilation and diarrhoea; when we further remember that, while the spasmodic type gradually changed into the non-spasmodic one, the general notion sprung up in our school, that Camphor is best indicated in cases marked by absence of cramps that is to say: Camphor would be best indicated in the non-spasmodic variety-then shall we understand, why the drug has not yielded the same therapeutic results of late, as of yore.
How much confidence Hahnemann had in Camphor as a remedy to allay cramps, can best be seen from the fact, that he insisted that the drug should even be tried at the stage of vomiting and purging for a short time, although he must have known full well, that at that stage of the disease, there is no pharmacodynamic relation-either allopathic or homoeopathic-between Camphor and the prominent symptoms of the choleraic disorder. It must then have been evident to him, that at the bottom of the whole disorder are the spasms; to remove them was, according to his view, the chief task of the treatment, having been confident, that choleraic evacuations would then abate by themselves, in the measures as the cause of the mischief is removed. Should Camphor fail, he would again have recourse to a remedy which has very little to do with choleraic evacuations, but very much spasmodic attacks-to Cuprum; and he would almost prefer the last mentioned drug to Veratrum Album, although the direct relation of this drug to watery diarrhoea must have been but too well known to Hahnemann, when he framed his rules concerning the treatment of cholera. All this proves, that Hahnemann’s treatment was chiefly directed against the spasms and in this he chiefly, if not exclusively relied on Camphor.
It is satisfactory to us to know, that subsequent clinical experience fully corroborated Hahnemann’s views; for not only has Camphor arrested the progress of hundreds of cholera cases at the very onset, but it has actually arrested the progress of the disease at the second stage, when vomiting and purging were already fully established. Tolle causam is a principle in medicine which helps us often, when we are at a loss to lay hold upon the exact homoeopathic remedy. In how far, and for how long, during the course of a disease, you are to rely upon the principle of tolle-causam alone, must be left to your judgment in every individual case. A good deal may depend in this respect upon the homoeopathic resources there are at your disposal. A remedy which would homoeopathically correspond both to the first and second stage of the disease, would no doubt be by far preferable to one which corresponds to the one (as Camphor does) and not to the other. Are we in possession of such remedies, or at least of one such remedy? It will be the task of my future, to examine this question. Before doing so, I shall however say something more in my next lecture, concerning the precise homoeopathic application of Camphor in the disease under consideration.
In connexion with the above and the following it is interesting to study Lauder Burton’s Text Book of Pharmacology, etc. article on Camphor.
