The elementary relationships of copper go in three directions: the horizontal direction to the nearby iron group on the one side, to zinc on the other, and to the vertical group relationship to silver. The sister relationships are expressed again in the frequent natural association of the iron and zinc with copper; they appear in the earth in the chalkosphere, usually in the sulphide forms, often with admixtures of arsenic and antimony.
Biologically the relationship to iron is still visible in that copper in the form of haemocyanin plays the same role in the blood of crustacea and mollusks as iron in the vertebrates. Even from antiquity a connection of copper to the blood formation process has been stressed. The agreement with zinc on the one side, with silver on the other, is found in the nervous system. Perhaps it is merely a foreign but still not absurd thought that a physical property as the particularly high conduction capacity for electricity and heat, as are peculiar to copper and silver, can be placed in relationship and compared in analogy to the especially strong tension in the nervous system. Finally must this especially great conduction capacity must appear again in conjunction with the living organism.
Likewise that it is precisely copper and silver which show in a high degree the so-called oligodynamic actions must be founded upon similar special physical properties. The observations of Naegeli with copper have been the point departure for these investigations. The millionth or milliarddilution which still act lethally or exert damaging actions on lower organisms (molds, bacteria, algae) permit one to think of catalytic influences which involves an electro-magnetic charge in the vital tension. If one uses only very slight amounts of very finely divided copper or silver for the disinfection or the destruction of algae in large amounts of standing water and on the other side fairly concentrated solutions of copper sulphate for the protection against parasites in wine cellars, then one can draw the conclusion from this, that the medium has significance for the optimute necessary, that it determines the degree of liberation of effective powers, the impetus power of molecules. If we add now a simple rule based on observation that below a definite optimum of division which exists for the damage of living organs, there lies another promoting, then we easily see that the various steps of concentration for the promotion and likewise for damaging are possible and that these optima depend upon the material. Actually with copper Richet has found several optima and minima in the concentrations for the development of lactic acid fermention.
The lethal action of copper has been medicinally sought many times in the human organism. In tuberculosis the results of this chemotherapy are in no way striking. On the contrary copper preparations have proven themselves in the attack upon intestinal parasites in accordance with the ancient conception (for example cupr. oxid. nigrum, the remedy of Rademacher in taenic and ascarides).
A local corrosive action is held by copper salts in common with most heavy metal salts. They rest on the precipitation of proteins, the formation of metal albuminates. This property is used in copper sulphate on mucous membranes and formerly copper ointments were employed for the stimulation of granulation on ulcers.
Acute poisoning with copper salts by mouth, in which copper sulphate and acetate come into consideration, show at first severe gastro-intestinal symptoms. The repugnant metallic taste of copper salts is very persistent. The vomiting whivh follows rapidly from copper sulphate is also therapeutically used, for example, in phosphorus poisoning it is a very suitable emetic because the copper at the same time renders the phosphorus harmless. However at present kali permangganate is preferred. The vomiting may also protect against further toxic manifestations. The vomiting occurs through the intermediation of the vagus. When this has been sectioned in animals there is no vomiting after copper sulphate. With very large doses of copper salts however a complete removal is not possible on account of the injury to the mucous membrane. The a severe gastro-enteritis appears. To the vomiting is added salivation, burning and pain in the esophagus, severe colic like pain in the stomach and intestine, meteorism, diarrhoea with tenesmus, at times with blood. Widening of the pupils, small pulse, cold extremities can complete the picture of acute poisoning. With a longer duration bile pigments are observed in the urine and often icterus, in the latter instance often a high grade anemia. Perhaps outside of the bleeding an accelerated destruction of the erythrocytes participates. Once 623 alterations in the red blood cells (anisocytosis, etc.) was observed. Debris of blood cells and microscopic hemorrhages have been described in all organs as autopsy findings. The trend outside of Rademacher and homoeopathy (for example by Hannon) stressed for the effectiveness of copper in chlorosis in place of iron might find some support in these toxic end damages. The biochemic connection of traces of copper which are found in the serum is not yet explained in respect to the hemopoietic system. Deficiency of copper in the food is said to lead to anemia. 624 In hemochromatosis and certain cirrhosis of the liver one finds increase of copper. 625 One might think also of a catalytic role of copper in the new formation of blood.
In a latter phase of copper poisoning severe nervous symptoms appear in the foregroun: vertigo, cramps with high grade cyanosis, especially severe cramps in the calves, trembling, paralysis, loss of consciousness. This syndrome has become the object for comparison for the homoeopathic use of copper in very acute states. The nervous effects also appear in acute animal experiment. At first fibrillary muscle contractions occur then muscle paralysis with complete loss of irritability, then cardiac weakness. It is noteworthy that a case of acute copper sulphate poisoning from an eczematous scalp, reported by Lewin, that symptoms developed after 24 hours which recalled the threatening state of cholera in the phase of asphyxia. Such pictures are seen in homoeopathic materia medica.
Even fatal copper poisonings do not run very rapidly, but death occurs only 7-10 days after onset. Likewise in favourable cases recovery is very slow and the digestive disturbances may persist for a long time.
Lewin denies in general the possibility that so slight an admixture of copper salts which could occur by the storing of acid foods in copper vessels or through the green discoloration of conserves with copper sulphate could be injurious and seeks to interpret such poisonings in some other manner. But when one thinks that outside of the quantity, many other conditions can be decisive, then one ought not to deny in general so many reported instances of poisoning.
Likewise chronic poisoning is denied by Lewin (apart from the local discoloration of the hair and teeth and irritative manifestations in the upper respiratory passages from inhaled copper dust). But a chronic copper poisoning is described by others, for example, Roberts saw anorexia, tenesmus, tremor and fainting; 626 recovery after seven months. That usually metallic copper dust is not absorbed, because the particles are still too large is probable. But to be recalled in regard to copper salt poisoning is that the slowly progressive non-fatal intoxication still causes prolonged after-effects and also goes over into a subacute stage. The excretion of copper occurs very slowely (through the bile, stomach, intestinal glands, pancreas, kidneys, salivary glands, and apparently also through the skin glands). Absorption in greater amounts also occurs from previously damaged sites, mucous membranes and skin. The storage occurs chiefly in the liver, then in the pancreas, spleen, kidney, nervous system and muscles. Copper is ingested in small amounts with many plants, which derive copper from the soil, and therefore is quite constant in the body. But the production of resorptive symptoms through small amounts obviously presumes frequent introduction in fine division.
CUPRUM METALLICUM (AND ACETICUM)
Provings on the healthy are found: Hahnemann, Chronische Krankheiten, 2 Aufl. Bd. 3, S. 212 (there also the first cupr. acet. provings of Franz: Arch. f. hom. Heilk. Bd. 3, S. 166 and a smaller number of symptoms of cupr. sulph. are found in Hahnemann’s Fragmenta de viribus, etc.
A greater part of the symptoms in Hahnemann’s writings are taken over from copper poisonings.
The use like iron in chlorosis and secondary anemia is almost as limited in homoeopathy as in older medicine. It is said that copper should be employed in chlorosis when iron has failed or after the misuse of iron. Furthermore copper has fewer symptoms of excited state of the circulation than iron. Pale cachectic appearance of the face and blue livid lips repeatedly come into expression. The provings and intoxications available in respect to the effectiveness on the red blood cells have already been mentioned.
A considerable lack of clarity in the picture of copper arises from the fact Grauvogl perceived copper as the chief remedy of the carbonitrogenous constitutional type. He came to this conception by mixing the Rademacherian conception with his idea of the three chronic miasms of Hahnemann. For Rademacher copper was the third of his universals, that is, remedies which were adapted for primary maladies of the entire organism. Since the two universals were given for the two other constitution of Grauvogl and ferrum for syphilie of Hahnemann or the oxygenoid constitution of Grauvogl, only copper remained for the psora of Hahnemann which was placed equal to the carbonitrogenous constitution.
But it by no means proceeds from what we know of copper that it especially promotes the carbon and nitrogen retention processes nor on the other side that it is able to balance them. Likewise the theoretic explanation of Grauvogl that copper is able to effect an improvement of such processes through increased oxygen intermediation, cannot be correctly maintained. At least it is not apparent why the still more marked oxygen carrier iron would not be a remedy for the same constitutional type. On the contrary we could count copper just as well as iron to the constitutional type which is characterized by excessive oxygen influence, namely the oxygenoid. This agrees throughly with the entire neuropathic drug picture which can be counted to the psora of Hahnemann is the clinical report that copper (just as zinc) is suitable for such maladies (in particular nervous) which can be traced back to the suppression of eruptions and secretions. And this report again goes back to Rademacher. That Hahnemann including copper amongst his antipsoric remedies states nothing since this finally happened to all drugs with persistent effects.
Of the trends of a carbo-nitrogenous constitution which today come near arthritism, practically nothing is found in copper. Moreover the reported aggravation in hot weather has no support from the provings protocols. (Moreover this aggravation appears in the oxygenoid constitution as well as the carbo-nitrogenous.) From the reports of Rademacher in which copper was of use under purely empirically obtained circumstances one cannot recognize in general any characteristic trends for the copper picture.
The accepted action of copper arising out of the provings as well as from use shows distinctly the chief trend on the nervous system. The outstanding trend is the general state of spasms: spasms recurring at irregular intervals in the voluntary nerve muscle system as well as in the fields of the vagus. The convulsive manifestations go from localzed twitchings of single muscles up to the most severe tonic-clonic spasms.
To begin with the general spasms: the severe epileptic attacks particulary nocturnal, when the aura rises from the knees, spasms from the hands and feet go upward; at first the thumb flexes then finally the hand becomes spastic and then the tonic-clonic spasm becomes general. The usual piercing scream which precedes the attack suggests a spasm of the larynx and esophagus. An excited state with disconnected babbling is observed at times clinically as the precursor of an attack. The same has been reported in cases of poisoning with cuprum aceticum, where, indeed, it amounted to a maniacal state. Great restlessness and fear of death are further warnings, considerable vertigo with loss of vision (on looking upwards), confusion, a heavy head, severe paroxysmal headaches, worse from contact and pressure also belong to this picture. The tendency to severity and to malignity is also taken over from the psychic picture of epilepsy. After the attacks the exhaustion is said to be great. Sleep in copper is very deep or restless from dreams and with twitching.
The convulsions in copper do not show epileptic nature alone, but also the hystero-epilepsy, particularly before the menses; in spasmodic dysmenorrhoea and uremic spasms (there usually cuprum arsenicosum) it is recommended, when the attacks have the above described course. Also spasms from dental origin or worms in children and other states of brain irritation (hydrocephalus acutes) can give occasion for thinking of cooper for the attack itself while other remedies as calcarea and chamomilla are preferred for the underlying situation. In worms one has also to think of the lethal action of large doses of copper. Moreover the symptoms of brain irritation from suppressed eruptions (measles, scarlet fever) are to be remembered.
Partial spasms appear particularly in the field of the vagus: spasmodic constriction of the esophagus with difficulty in swallowing, “fluids roll audibly through the pharynx spasms of the bronchi with attacks of spasmodic coughing; a very severe constriction in the region of the xiphoid or a cutting transfixed pain from the xiphoid process to the vertebra (probably a spasm of the diaphragm) with failing or piping voice, “the patient must compose himself in the agony of death.”
After this description the old formulae of copper in whooping cough becomes understandable. As in all convulsions here also, the cyanosis is characteristic. Squinting, twitching, cough so that the child loses its breath or vomits spasmodically, afterwards lies down for a long time as if dead, then breathing gradually recurs again-the description of a severe copper whooping cough. Drinking cold water may abort the attack at the beginning (likewise other severe spasmodic coughs with suffocative attacks).
The nocturnal aggravation also holds for whooping cough. Spasmodic dyspnoea, accelerated, short, labored breathing, spasmodic asthma with rales in the chest are similarly characteristic indications for copper.
The spasmodic character of copper extends itself to the maladies of the abdominal organs: spasmodic constrction in the stomach or abdomen, spasmodic vomiting, board-like rigidity but very sensitive abdominal wall, intermittent gastric spasm or intestinal colic of the most severe type, tenesmus as well as constipation as well as choleriform, gushing, watery, green diarrhoes. The picture of cholera in the convulsive state will be completed by cold, cyanosis, precordial anxiety, tendency to collapse and particularly the very suggestive cramps in the calves in copper. The comparison of copper with cholera has been previously mentioned. For Hahnemann and his contemporaries in any case copper was one of the most important remedies for cholera (besides veratrum and camphor). Fortunately we lack experience. In any case the tendency to intermittent spasms, collapse through diarrhoea is important for copper, particularly in children.
The intermittent, paroxysmal spasmodic character goes through the entire picture of copper. The spasms are general or localized, the general tonic-clonic, the local cramps in the calves tonic. Fear is mentioned as particulary giving occasion to the attacks.
1. General and partial spasms in the voluntary and spasmodic states in the vegetative nervous system.
2. Connection with blood formation.
Worse at night, before the menses, from contact, cough from cold air.
Better from cold drinks (whooping cough; also colic, vomiting and spasmodic swallowing).
Causative factor: suppressed eruptions; fear?
The metal has proven useful in the D 6 butalso in the D 30; the salts are usually employed in the lower and middle potencies.
Silver stands close to copper chemically and pharmacologically. The so-called oligodynamic actions were first observed by Naegeli 627 with these two metals. The contraction of the bands of chlorophyll in the plasma membrane of the alga, spirogyra, was the indicator of these actions. From many investigations which have since been concerned with this problem, it proceeds with certainty that the metallic silver in distilled water such as conductivity water goes into solution, and indeed in an amount which corresponds to the D 5 P 0 dilutions is explained in all probability that metal particles are absorbed by the glass walls and are slowly given off again into the water so that after repeated rinsing of the vessel there is still a dilution of the metal in the D 6-D 7. This shows distinctly depressing and lethal effects on bacteria.
At the time of Hahnemann only silver nitrate AgNo3 was employed and it appears quite remarkable that at that time Hahnemann 629 should have seen metallic silver effects in the organism. Because the general view is expressed by Sachs 630 when he states: “Metallic silver is insoluble in the animal organism and therefore cannot serve as a medicament.” A single observation such as that of White, 631 in which a patient who accidentally swallowed a silver coin which was carried for 18 months was cured of epilepsy also awaken much confidence on the effectiveness of metallic silver. The certainty with which Hahnemann introduced metallic silver into the drug treasury is all the more remarkable. He has obtained splendid confirmation in this respect by recent investigations.
ACTION AS COLLOID AND SALT
It has required a large series of studies 632 in order to bring proof that the actions of the colloidal metal in its chief manifestations are the same as its coresponding salts. Colloidal silver preparations constantly split off silver ions in watery solutions and the presence of these ions is decisive for the action. The hydrosols, that is, the water dissolved colloids have the same action as the very low doses. For a decision on the activity to dissociate. If now, in many textbooks of materia medica silver is denied having any general toxic influence on the organism, then this obtains only in the form where one employs it as the metal. But even poisoning from absorbed silver nitrate is denied. “Resorptive silver poisoning does not occur in man, only a grey black discoloration of the skin and many internal organs develop after the year long use of silver compounds through the deposit of insoluble silver (argyria).” 633 But Lewin 634 finds an acute as well as chronic poisoning with silver. The corrosive actions from silver nitrate as it is employed externally in the usual case, are slight in the stomach because of the combination with protein and chlorine so that often no symptoms are observed from the accidental swallowing. An absorption of silver compoundes certainly occurs, not only from the stomach where the silver albuminate dissolves in sodium chloride or perhaps silver chloride may be taken up, even from the skin. According to Lewin poisonings in the human are observed when silver nitrate solutions have been used for several years as a dye for the hair. Indeed the mere fact that agyria exists proves absorption. Outside of the intestine silver is excreted through the kidneys (according to Lewin but denied by others) and what is important for the action of silver, also in the stomach after parenteral administration. Thus it is understandable that gastric manifestations can occur which are not explainable through primary local influence. The partial retention of silver in the tissues conditions agyria. The deposit is found in the skin perhaps in a reduced from, perhaps, also in the upper layers in organic combination as under the rete malpighii and cannot be removed by any measures. Lewin mentions that besides agyria at times stomatitis without salivation, gastritis, albuminuria, depression, dullness, weakness of memory, ear noises difficulty in heating, visual weakness and spasm of the eye muscles develop. At times oedema of the lower extremities and ascites develops. In older materia medica texts 635 cachexia, emaciation and dropsy are mentioned as results of prolonged extensive use of silver nitrate.
Even the Arabian physicians knew these actions of silver. T.R. Kochlin 636 states: “silver was employed by the Arabian physicians against dropsy, but can also produce a fatal dropsy.”
Of acute symptoms of poisoning there are severe gastro-intestinal symptoms, vertigo, spasms, loss of consciousness, loss of sensitivity over the body and involvement of cardiac activity, widening of the pupils which do not react to light as Lewin also cites. In animals after injection of silver compounds paralysis
of the central nervous system and soon after death is observed.
The official position toward silver as a drug has appeared in a new place since the employment of colloidal silver nitrate had significance and indeed in the first line as a strong external corrosive agent which contracted the smallest vessels and created a firm but superficial scab and at the same time worked antibacterially. On this rested its local use on the skin and mucous membranes. The sole internal use even today of silver nitrate in school therapy is in gastro-intestinal affections and in particular in chronic gastritis, gastric ulcer, less often in chronic intestinal diseases and diarrhoes. The action on the gastric mucous membrane moreover has been viewed as similar to that on other mucous membranes as, for example, in urethritis gonorrhoica, that is, astringent to corrosive and disinfecting. But we shall still learn the gastric symptoms of absorbed silver, which lie near to a healing effect in gastric affections without one tracing these back to crude effects.
But the uses of silver nitrate are entirely neglected in nervous diseases. Formerly it was recommended epilepsy, chorea, still later in tabes and other diseases of the spinal cord. The indications in angina pectoris and cardiac irregularity were still mentioned by Vogt, furthermore the use in older times in dropsy and ulcerative cachexias, which, as we find can also be provoked through the persistent use of silver nitrate. But all these indications were obtained purely empirically, ab usu in morbis. An entirely new field, the infections diseases, was opened for the internal use of silver through the introduction of colloidal silver (by Crede, 1897). One now recalls that even the Macedonians treated wounds by covering them with silver discs and erysipelas was treated in some regions of Italy by the same remedy In all types of septic affections, in particular the septicemias diseases collargol has been employed, in joint rheumatism and erysipelas, in pneumonia, in joint rheumatious and erysipelas, in pnemonia, in typhoid and paratyphoid, in appendicitis, furuncul- sis, phlegmons, anthrax, cerebrospinal meningitis and scarlet fever, diphtheria, dysentery, etc. The results obtained have been judged differently, indeed nothing else could be expected from a use so generalized. But two manifestations seem especially frequently observed after the employment of collargol: fall of temperature and subjective sense of well being of the patient for a few hours after the injection. But on the influence on the septic or in general infections diseases, one is not concerned with a peculiarity of colloidal silver but an action also approximated by other metal hydrosols. Only the colloidal silver is especially frequently employed.