As to the general experience in this country with regard to the Camphor treatment of cholera, it is one the whole, I may say, about the same as it is in Europe and America. It is an excellent remedy in some cases; in some other cases it fails; it has been known to fail on a large scale in certain epidemics, and the disappointment thus caused resulted in an entire neglect of the drug in further cases. In short Camphor played, and plays up to this day, the same role in our school as certain empirical remedies do in the ranks of the old school of medicine. I am not aware if there have ever been made experiments on a somewhat large scale in this country to treat all cases of cholera indiscriminately by Camphor, from beginning to end. What I do know from my own experience, and from the experience of others is this, that in the spasmodic variety of the disease, in the sense as I have explained it, the drug acts just as beneficially here in the first stage as it did in Europe. I can also say from my own experience and that of others, that whenever the type of the variety is homeopathic to Camphor, the drug will act well, even after purging and vomiting has set in. Camphor, or one of its analogues, when indicated, strongly deserves a fair trail, and should not be timidly abandoned after an unreasonably short time. And unless the choleraic evacuations are so prominent, that they by far outweigh all other symptoms, I can hardly see how we can benefit our patient better in the spasmodic variety, as I understand it, than by preserving with Camphor or with some of its analogues. Camphor in such cases of cholera is just what Aconite would be in the chill likely to lead to catarrhal inflammation when left alone. So long as the effects of the chill are not localised, there is, according to clinical experience, no drug so apt to cut short the coming mischief as Aconite; but when the effects of the chill are once localised at a certain organ, Aconite is out of place; a drug is called for, capable by its physiological affinity to certain definite organs of the human body, to cope with the disorder at its very seat. Analogically speaking, we ought then to abandon Camphor. Experience has taught us however, that in the spasmodic variety the therapeutic efficacy of Camphor does go somewhat beyond the period of choleraic localisation, and we should so much the more continue the use of this drug of of some of its analogues, within certain limits of time as there is as yet no drug known in our Materia Medica which, in its physiological action on the healthy would run so far parallel with spasmodic cholera, as to produce with something like certainty spasms-arterial or muscular-followed by rice-water discharges from mouth and rectum. It is no use getting impatient with your Camphor (which is at any rate a reliable antispasmodic on homoeopathic principle) or with any other drug similar in its action to Camphor, as long as the leading indications are all on its side, and not on the side of the drug in whose favour Camphor is intended to be abandoned.
When I shall come to discuss the therapeutical relations of Cuprum and Veratrum to cholera, then I hope I shall be able to show you, that pharmacodynamic and therapeutic virtues of these three drugs-Camphor, Cuprum and Veratrum-are by no means convertible quantities. Each of them has, moreover, its peculiar sphere of action, its peculiar sphere of usefulness; and where the one or the other is indicated, we should hold fast to it, and set our hopes for salvation of the patients on it. When for instance cyanosis and algidity are and remain the chief feature of the choleraic disorder and there is all ground to believe that they proceed from the state of the vaso-motor nerves, in other words, that they are, as to their origin, neurotic and not haematic, then it is advisable that Camphor or one of its analogues should be continued long even after the characteristic cholera evacuations may have made their appearance. But to say: because cyanosis and algidity form in a more or less pronounced manner one of the standing menaces of cholera, therefore Camphor is to be in indiscriminately administered, and to the exclusion of all other remedies-is, to say the least of it, not what I would advise you to do.
There was a time when I thought extreme cases of poisoning had actually revealed that Camphor is capable of producing in its victims cholera-like purging and vomiting. Taylor in his Medical Jurisprudence 1879, states that infants poisoned by Camphor die of vomiting and purging and convulsions. Then I had fished up a dubious case of alleged Camphor poisoning, in one of the criminal records of Bengal, to the effect, that one out of about ten witnesses had said the man had died with all the symptoms of cholera, vomiting and purging included. Then a well experienced medical practitioner of this city published some years ago the case of a child who swallowed a lump of Camphor and manifested all the signs of cholera: spasms, vomiting and purging of rice- water evacuations. Since however Dr. Brajendra Nath Banerjee, L.M.S., of Allahabad told us lately that he had seen rice-water stools in purging from Jalap, Scammony and even Eno’s Fruit Salt I have come to reconsider the matter, being now of opinion that under the cholera-endemic influence of this country, any diarrhoeic discharge might, under certain conditions, assume the form of rice-water stools. Since then I have looked into Taylor’s Edition of the above mentioned work, published in 1883, and have found nothing there with regard to infants poisoned by Camphor dying of purging and vomiting. Out of various cases there is only the case of one infant mentioned that died in the way described, but there is no mention made of rice-water discharges. On the whole it is my opinion, so long as all the cases of Camphor poisoning coming to us from Europe or America are silent about cholera-like evacuations, we must not attach much value to what passes in this respect in this country. Any one poisoned in this country by Camphor is sure to suffer from an attack strikingly similar to the spasmodic variety of cholera; what wonder then, if the rest should come, so to say, by itself; especially in certain seasons of the year. Have we not seen here in India whole epidemics of intermittent fevers, where the rigors of the cold stage gradually merged into a choleraic attack with its rice- water evacuations and vomit?(*See second lecture*) In a similar way then, may it come to pass in Bengal, that a Camphor-rigor merges into a choleraic attack with rice-water discharges.
I have endeavoured, gentlemen, to assign to Camphor its proper sphere of action. It remains now for me to give you some practical illustrations of the use of the drug so often mentioned during the course of this lecture. I have selected for that purpose a number of cases as given by Dr. Russell in his Treatise on Epidemic Cholera. There are on the whole 75 cases recorded, out of 365 cases treated by him conjointly with the other medical officers attached to the Homoeopathic Dispensary of Edinburgh, during the epidemic of 1848-49. The author states that the object of selecting those 75 cases for publication was rather to illustrate the varieties of the disease, and the corresponding treatment, than to show a brilliancy of result. In fact out of the 75 cases recorded there are are 19 which ended fatally.
CASE XXI.
N.G., aged 21, a woman of intemperate habits. When walking in the street to-night at half past eleven, she was suddenly seized with severe cramps in the abdomen and legs. She would have fallen had she not been supported and led into the house. We saw her first at 12 P.M. on the 21st of October. Her abdomen was much swollen, she had severe cramps in the legs, shivering and coldness all over the body. Frequent muttering delirium, tossing about in the bed; complained much of cold. Great desire to vomit, little rejected; pulse slow and weak.
Tincture Camphor, in water every quarter of an hour.
22nd, 1 A.M.-much better.
This is a good specimen of a Camphor case, and Camphor did its work well.
CASE XXII.
Mrs. T., aged 23, subject to dyspeptic attacks. She awoke this morning, 4th November about 6 A.M., with vertigo, noise in her ears, nausea and pain in the epigastrium. We first saw her at 7 A.M., same day. She had vomited (three times in an hour) a large quantity of a greenish watery liquid. She complained of pain in the stomach and head. Skin cold; pulse 120, irregular; painful dry retchings, no vomiting.
Tinct. Camphor every 10 minutes. 1 P.M. no vomiting, occasional pains in the stomach and through her head; taken no food; rather thirsty.
Continued Camphor every half an hour till relieved.
5th, November, noon.-Said she was better; had some weight and pain in epigastrium, and felt a little nausea.
Continued Camphor.
6th November, 2 P.M.-She was sitting up and was quite well.
This was strictly speaking not a cholera case considering that the vomit was bilious. Iris Versicolor would have restored the patient prompter, I dare say; of course this is not meant in a critical spirit, the drug having been at that time entirely unknown to our school. The case was a sort of sick-headache, aggravated by epidemic influence, or perhaps set up by it. Anyhow, it was decidedly neurotic in its nature. The vertigo, the noise in the ear, remind one of the premonitory symptoms of the spasmodic variety of cholera as described in a previous lecture; Camphor was the right remedy, and would have been so, had the vomiting even been of a decidedly choleraic nature. Some might have given preference to Arsenic; but Camphor corresponded at that time to the genus epidemicus; it was therefore fair to decide in its favour.
