Let us however, not forget that, all the above mentioned symptoms-dyspnoea, algidity and cyanosis-may just as well originate in a state of cardiac paresis, though the sympathetic system in general may not be particularly disordered. In fact, as far as the circulation is concerned, the consequences of a weak action of the heart are just the same, as what follows spasmodic contraction of the muscular coat of the arteries. In the first case there is deficiency of propelling power; in the second, there is increase of resistance to the flow of blood through the vessels: the effect, it is evident must be in both cases, well- night the same-impeded circulation and venous congestion, incomplete aeration and oxydation of the blood hence dyspnoea, algidity and lividity, and as a secondary consequence, congestion of the portal system, diarrhoea, and-under the influence of epidemic cholera-rice-water discharges. We shall see hereafter that such a combination and sequence of symptoms may occur during a cholera epidemic. Yet Camphor, which is nothing if not spasmodic would be out of place in such a contingency, where paresis of the heart’s action is, if not at the root of all the evil, at any rate, prominently associated with the danger attending the existing evil. If you want therefore to make it sure that the dyspnoea and cyanosis eventually present at the very onset of cholera is really due to a spasmodic condition of the arteries, in other words, if you want to make it sure, that Camphor, or one of the drugs analogous to it in action, is, beyond any further doubt, the homoeopathically indicated remedy in the case before you; then you will have to take the state of the patient’s heart into consideration, before coming to a definite conclusion on the subject.
After this detailed differentiation, I believe, it should not be difficult to say in a given case of cholera, even when preceded by diarrhoea, if it belongs to the spasmodic or non- spasmodic variety, and consequently if Camphor, or one of its analogues, has to be prescribed or not.
It has been maintained by some men of our school- Dr. Rubini is one and foremost among them-that Camphor should be used at any stage of the attack, and not only, as instructed by Hahnemann, at the beginning when vomiting and purging have not yet set in at all, or, at any rate, have only gone on a short while. They say: Camphor may not be homoeopathic to the vomiting and purging; it certainly is to the state of algidity and cyanosis, which plays so prominent a part in the disease under discussion and constitutes in fact one of its greatest perils. In other words, they maintain that the motives which prompted Hahnemann to advise the administration of Camphor for a time even after the choleraic evacuations had set in-that the same motives may be urged in favour of the application of the drug in any stage, even when vomiting and purging are already far advanced. It is they who assert, as I have already mentioned before, that Camphor is the specific remedy for cholera in all phases and stages of the disease. Dr. Rubini has supported his views by facts; and the best way to lay his claims in favour of the drug before you is, to state them in the words of Dr. Richard Hughes, who, without being prepared to adopt in their entirety Dr. Rubini’s general convictions on the subject, advocates his cause in a fair spirit of impartiality.
Hahnemann he says, had the gratification of hearing of the great success which attended all who followed this advice of his, and of numerous instances in which the family use of Camphor had checked the earliest symptoms of the prevailing scourge. In the epidemic of 1849, British physicians had an opportunity of testing the value of the remedy: and Dr. Drysdale of Liverpool and Dr. Russell of Edinburgh vied in their praises of it. The latter who has written a book on the disease, says: ‘It is our firm belief that Camphor is an almost infallible remedy for cholera, if given from the very outset’. In 1854 the same testimony was given to its value in England, and from Italy still more striking evidence was adduced as to what it can do. Dr. Rubini of Naples-he who has given us a proving of Cactus Grandiflorus-states that during this epidemic he treated together with his colleagues, 592 cases with Camphor alone without a single death. He gave it in the spirit of Hahnemann’s instructions-ad libitum doses of a saturated tincture, and relied upon it to the exclusion of all other medicines in every stage of the disease. You will find a full account of his observation in the tenth volume of the monthly Homoeopathic Review. Much exception has been taken to his statement of results, as exaggerated; but I think without just cause. Dr. Rubini is a physician of undoubted experience and judgment, not to speak of trustworthiness and his published affirmations have never been contradicted. He does not mean to say that all his cases were in collapse; on the contrary, of a set of 200 treated in his institution, it is expressly mentioned that collapse occurred in fifteen only: What our colleague wishes us to understand is, that in an epidemic of Asiatic cholera, in which 377 cases came under his own treatment, and 215 more under that of his fellow practitioners, they gave nothing but Camphor, and lost no patient. There must have been the usual proportion of severe cases among these, so that the results are most gratifying. We have hitherto been jubilant about reducing the ordinary 50 per cent. mortality from cholera to one half; but 26 per cent. of deaths is a melancholy rate after all. We are bound to look in directions which promise something better still, and Dr. Rubini’s extension of Hahnemann’s Camphor treatment deserves our most respectful attention. Mr. Proctor, indeed, reports less favourably of it in the Liverpool epidemic of 1866. But further experiment is required. In the same epidemic Dr. Rubini treated 123 cases, and again his mortality was nil.
It is natural to inquire whether the report of the anti- choleraic virtues of Camphor have spread beyond homoeopathic regions, and whether any trial has been made of it. This might well be, as in its case there are no posological prejudices to be overcome. I am only acquainted, however, with one miserable instance of its use in the last epidemic, where it was given to a few patients at the London hospital. The physician did not deign to follow our method of administration, viz., dropping it on sugar, but gave it suspended in water. He thus nauseated his patients and burnt their throats and consequently, instead of exhibiting it in a better form, thought fit to abandon its use altogether. Both Ringer and Wood, however, now recommend it; and the latter states, that it forms the chief ingredient in the popular cholera mixtures sold in America.
I shall quote to you now what Dr. Hoyne in his Clinical Therapeutics has to say on the same subject:
Camphor is certainly the most frequently employed remedy in the treatment remedy in the treatment of cholera; but it is by no means a specific, as Rubini would have us believe. Dr. Rubini, some years ago, claimed that it was a specific, not only for the invasion of the disease, but for every stage, if used properly. The proper use in his opinion, consists in giving five drops of his solution of Camphor every few minutes, until reaction sets in; his solution was made by distilling a pound of alcohol so much overproof that it would dissolve a pound of Camphor. He reported 377 cases cured with this remedy alone, and no deaths. If all persons were affected precisely alike, and the disease always presented exactly the same symptoms, it is possible that Camphor might might prove a specific. But that cases and symptoms differ in different epidemics is proved by the face that nearly all cholera specifics contain a large amount of Camphor, and they all fail in the majority of cases. Dr. P. Proctor (British Journal of Homoeopathy, Vol. XXV, p. 92) found Rubini’s solution to fail in all but two cases, while Veratrum alone was sufficient for a cure in twenty-seven cases, and Arsenicum in thirty-three. More than one physician has concluded that Rubini’s cases were not cases of true Asiatic cholera; but examples of cholerine or choleraic diarrhoea. Dr. Hirsch states that reports had reached him which were not altogether corroborative of the remedial power of Camphor in cholera. He also quotes from Rubini’s report, in which he shows that after station in the paper that he had cured 377 cases in the body of the report, he (Rubini) says, he had but few fatal cases.
To this I may add the evidence of Dr. Quin who lost-at the very epidemic for which Hahnemann had prescribed Camphor with such a confidence of success, that he predicted that not one amongst hundred would die-11 patients out of 71, treated by Camphor alone. And I may further add, that the very argument upon which Dr. Rubini’s treatment is based, is, as far as I am able to understand, no less shaky in its foundation than the facts upon which his assertions seem to be built. For granted that algidity and cyanosis represent the chief peril in all cases of cholera, it should not be forgotten, that cyanosis and algidity may be owing to two different, actually opposite, pathological conditions. They may be owing, as has so often pointed out before, to a spasmodic state of the arterial system; or to a state of paresis of the heart; and it is not easy to be seen, how one drug, be it Camphor or any other drug, could be primarily homoeopathic to both the one and the other pathological state.
