A WIDE field for study, and one scarcely yet trodden by the therapeutist, is that which gives us substances capable of causing and curing asphyxia. What of Oxygen in animal tissue invariably leads to a general disturbance, the central phenomena of which appear in respiratory and cardiac symptoms. The blood in the capillaries is retarded in its flow, and at length fails utterly to pass into the veins. Then the heart, which at first worked harder to overcome the resistance, beats more and more quickly, but at the same time more and more feebly, until it finally becomes paralyzed. Such a calamity follows, first, because the heart muscle is exhausted by its undue efforts, and secondly, because its blood, deprived of Oxygen, fails to impart its essential stimulus.
The symptoms which more or less characterize asphyxia are; “Pectoral anxiety, dyspnoea, rapid feeble pulse, surface coldness, restlessness or stupor, with cold blue skin”.
Among the possible remedies, which may be added to those already so well-known, are the following: Carbonous Oxide (CO) is one of the few substances which can, like Oxygen, combine with, or unite itself to the red corpuscle. Hence its poisonous action depends principally upon the displacement of Oxygen, with consequent suffocation.
At first there is a notable increase in the blood pressure. There is flushed face, deep-red as from venous hyperaemia. A characteristic headache sets in, throbbing in the temporal arteries; lightness and constriction, worse about the temples; palpitation of heart. The patient soon feels stupid, confused or acts like one drunk. Respiration becomes stertorous and slow; the breath becomes cool, and complete unconsciousness, or trismus with convulsions, follows. The surface of the body, at first red, soon turns livid, cyanotic, and the temperature falls perceptibly. Death may close the scene, or partial recovery occur, with sell defined Hemiplegia. Other cases end in perfect recovery.
This picture forcibly reminds one of the effects of Opium, and doubtless Carbonous Oxide will compare with the latter remedy in practice. The suddenness of its symptoms, the cerebral hyperaemia, and subsequent Hemiplegia, suggest its trial in Apoplexy and also in embolism. As a remedy serviceable in asphyxia arising from pulmonary affections, it would seem to stand between Carbo Veg. and Opium having the hyperaemia of the latter with the coldness of the former. Cases of poisoning with the gas have developed Pleurisy, Bronchitis, Emphysema, with bloody sputum, weakened vesicular murmur, and Pneumonia. Its subjective symptoms are: “Anxiety in the chest or feeling of a heavy load on the chest etc”. There are also recorded, rattling of mucous in the air-passages, bloody mucus raised from the bronchi, heat in chest, and abdomen, extremities cold.
Aniline (C6H5NH2), thought chemically different from Carbon, containing Hydrogen, Nitrogen, etc, behaves like the Carbons, and may be medicinally considered with them. Aniline is not an intense poison, but its effects are those of asphyxiation. The patients, after inhaling its fumes, are seized with giddiness, and may become insensible. Face and body become cold and blue, pulse slow or imperceptible, breathing, heavy and labored. If conscious and able to speak, he complains of pain in head and chest. Compare Hydrocyanic Acid.
The Sulphate of Aniline has been proved and successfully administered by Dr.C. Wesselhoeft. He has used it in diseases accompanied by excessive flatulence, loathing, disagreeable taste, and costiveness, common after too much fruit, cabbage, beans, etc. Compare with Carbo Veg., Graphites, etc.
Nitro-benzine (C12 H5 NO4) is used in the preparation of perfumes, and also as a substitute for oil of bitter almonds. It is much more poisonous than its near relative, Aniline. When inhaled, it causes a benumbed feeling in the head, anxiety, want of breath; increasing sensorial confusion, and convulsions or stupor follow. The pupils are dilated, the face purple or livid, breathing slow, difficult, and the pulse small, slow, accelerated, or irregular. Convulsions are tetanic, with trismus and spasms of the flexors, especially of the upper extremities, and are followed by coma. One can scarcely fail to see in this group of symptoms a marked resemblance to Hydrocyanic Acid.
Carboneum Chloratum (C2 CL2) acts very much like chloroform, but rather more slowly. The main characteristic is its depressing influence on the heart. The heart-beat falls to forty-eight per minute, with extreme lassitude and deep sleep. It may prove a remedy in cardiac affections, or in diseases with impending cardiac Paralysis.
The Bisulphate of Carbon (CS2) is of interest, as we may have to antidote its effects in workmen who prepare the caoutchouc for rubber toys, etc. Its first transient effect is one of exhilaration. The prover is disposed to laugh and chat like one under the stimulus of Alcohol. But intermingled with this excitement is a depression, which eventually becomes persistent.
A constant symptom is an intense oppressive headache, spreading from the root of the nose towards the temples, with a feeling of giddiness and intoxication. Muscular weakness is quite general, especially in the the lower limbs, in some cases amounting to paresis. The mind becomes distressingly apathetic, with inability to find the words wanted. Speech is stammering, as from lingual Paralysis.
A noteworthy symptom of the nerves is a lancinating tearing pain, erratic and inconstant, associated with formication or anaesthesia. In other instances, it is associated with sour belching and borborygmi. The lower half of the body is icy-cold. The senses are all diminished. Ringing in the ears seems to be a characteristic symptom. (Compare Bromhydric Acid) Congestion of the lungs has been noticed and even tubercular deposit in rabbits. This circumstance together with dyspnoea and a very characteristic night fever, suggest the drug in Pulmonary Consumption.
As an anaesthetic it is far inferior to the others, and as a substance tending to produce asphyxia, it cannot compare with the previously mentioned drugs. It seems to act paralyzingly on the nervous centres very much as does Chloroform.
The nervous sensations, muscular debility, loss of sexual power, etc. suggests its applicability to diseases of the nervous centres, especially of the spine. Mayhap it may even find a place in the treatment of the Neuralgia incident to Loco-motor Ataxia.
Its gastric and enteric symptoms place it between Sulphur and Carbo Veg.; fetid eructations heart-burn, pressing-stitching pains form pit of stomach to cardiac region, relieved by loud belching. Thin, yellow evacuations 5 A.M., etc.
Of the Ethers, with Chloroform and Chloral, not much is known therapeutically; yet in some cases their employment will prove satisfactory and highly advantageous.
As a general fact, it ought to be remembered, that the Ethers especially Chloric Ether, cause a predominance of respiratory symptoms (Chloroform).
Ether (especially Chloric Ether, with which these symptoms have been confirmed) may be given in convulsions, whether epileptic, hysterical, or puerperal. The characteristic symptom is intense dyspnoea. Hence it may be remedy in such cases as have what is termed convulsions from asphyxia.
This same characteristic belongs also to Nitric Ether, Ethyl Nitrate, etc.
Ethyl Nitrate, as contained in the Sweet Spirits of Nitre (C2 H5 NO2), comes to us recommended by Hahnemann in Typhoid conditions, with well-marked sensorial apathy. When aroused, the patient answers intelligently, but quickly relapses into his state of sleepiness and indifference. Here the drug rivals Phosphoric Acid. But there are other applications of the drug, particularly that which calls for its present recommendation: “Breathing slow and regular, but on walking a short distance, it becomes hurried, then quick, difficult, and painful, with a distressing sense of constriction under the sternum. On walking, the heart beats rapidly and tumultuously. How suggestive this is of Angina Pectoris, or of Hypertrophy of the Heart! It is very similar to the well-confirmed characteristic of Aurum Mur.
The Amyl Nitrite (C5 H11 NO2), causes constriction in the throat, which extends to the chest. There is, however, not much dyspnoea; but the circulation is wonderfully altered. The venous and arterial blood are said to become of the same hue. Oxygenation is lessened and with it the animal heat, the whole system becomes weakened and relaxed.
The vascular phenomena are due to a paresis of the vasco-motor nerves: Throbbing, bursting fullness in the head, protruding eyes, throbbing in the ears, flushed face, neck swollen, fulness of the chest, anxiety, with cardiac oppression and tumultuous heart-action, constriction and pain about the heart, general, sweat. The constriction of the chest is evidently not a true dyspnoeic symptom, but arises from hyperaemia.
This drug may often be called for in sudden derangements of the circulation, as blushing, flushing, of the face at the climaxis, hysterical anomalies, etc. Also in heart affections, where it is similar to Cactus and Glonoine. Its application in Epilepsy is not Homoeopathic since, it there acts only palliatingly by lessening spasm of the blood-vessels. It is recommended in asphyxia from drowning, Chloroform, etc.
Nitrous Oxide (N2O), is one of the few gases capable of sustaining life, at least for a while, after the withdrawal of Oxygen. Under its effects, the experimenter seems to be in a sort of ecstasy. Fancies and thoughts are vivid, intense and generally pleasant. The mind tries to grasp the marvellous and supernatural. The senses are all exquisitely acute. There is a feeling of muscular energy and often a strong inclination to laugh. This cheerfulness and activity sometimes continue for several hours after the inhalation. The temperature of the body, while inhaling the gas, rises steadily and keeps pace with the mental exhilaration. The nerves experience a not unpleasant thrilling, vibratory sensation. In fact, the prover is living too fast, crowding the work of days into a few moments. The symptoms thus far remind one of the extravagant hallucinations of Cannabis Indica.
When the gas, however, is inhaled in large quantities or without the admixture of air, anaesthesia quickly follows. The mental ecstasy is but transient. But hearing remains acute, much longer than the other senses.
Sometimes attacks of fainting occur, with a feeling of oppression of the chest. At other times, convulsions set in, resembling Epilepsy or Hysteria.
I can recall a case of a colored woman, who took the gas at the dentists. For days afterwards, she was subject to spells of semi-consciousness, which were preceded by a numb feeling in the head, spreading thence over the body. Then she would fall backwards to the ground.
In the open air, the attacks were often postponed, but were more severe when they did come. While at work, she was free form attacks, but while seated or unoccupied, the seizures were frequent. She was conscious of feeling sick, but could not help herself. She often complained of a drawing in the neck, as from contraction of the skin.
With these suggestions, could not the laughing-gas be utilized as a medicine? Some of its symptoms remind one of the Ethers and their compounds. These semi-conscious spells are not uncommon in Hysteria. Here Nitrous Oxide may serve as well as the frequently used Moschus.
A question presents itself, while considering the efficacy of Ethers and similar substances. Of what Homoeopathic value are they in the treatment of that dread calamity, Puerperal Convulsions? There can be but one answer to any such query, and that is, their value depends upon their Homoeopathicity. But with this general answer ever in mind, may it not be asked, when are they indicated?
Certainly only when characteristic symptoms agree with the individual case under treatment.
Ether will help if there is opisthotonos, unconsciousness, violent convulsions, and especially intense dyspnoea.
Chloroform is antipathic, except for the intense precursory excitement; or, later, for deep coma, stertor and impending cardiac Paralysis, with blue, cold surface. The order of they symptoms here, suggests a similarity of Hyoscyamus; and I believe Dr. Lippe has anti-doted the effects of chloroform with this drug.
The Carbonous Oxide must wait confirmatory evidence : but, as similar to Opium, it ought to receive attention.
Nitrous Oxide produces symptoms like Hysteria, but should not be forgotten in the more alarming Puerperal Convulsions.
The mode of administration deserves a passing notice. I have no quarrel with him who prefers the crude preparations, but think, nevertheless, that more certain and abiding results will follow the use of potencies.
Dr. Allen, in his valuable Encyclopaedia, has taken the precaution to indicate the method; of preparation as follows; Chloroform and Ether, in Alcohol; Carbonous Oxide and Nitrous Oxide, in distilled water. Hahnemann gave the Sweet Spirits of Nitre dissolved in water; and suggests that it should be old enough not to redden the cork. Amyl Nitrite, it is claimed, acts best by inhalation, although many symptoms have resulted from its use prepared in Alcohol. The Bisulphide of Carbon has been employed by Allopaths as a local application in Neuralgia. The dangerous and awkward method is quite happily unnecessary, since, its successful use in potencies is well-attested.