– TESTE A, GROUP REMEDIES, GROUP iV,ARSENICUM ALBUM
– White arsenic-Deutoxyde of arsenic.
– This compound, which has been found in a free state in nature, but seldom and in small quantities, is generally taken from cobalt mines.
– It is obtained by roasting the arseniferous ore, in reverberating furnaces, with long horizontal chimneys.
– The arsenic oxydizes, and is changed to arsenious acid, which condenses in these chimneys, where it is collected for the purpose of being purified by new processes of sublimation, after which it is fit for use in the arts and in medicine.
– Arsenious acid is a solid substance, generally in semi-transparent pieces, like glass that has lost its polish, or of a dull white on the outside, but looks like glass on the broken edge, or it is sometimes entirely opaque.
– If pulverized, provided not too finely, the powder looks lie sugar.
– Its specific weight is 3.738.
– Semi-vitreous, it dissolves in 103 parts of water at a temperature of 15, and in 933 parts of boiling water ; if opaque and white, it dissolves in 80 parts of water at 15, and in 7.72 parts of boiling water.
– The taste of arsenious acid is at first very feeble, manifests itself slowly, and becomes at last slightly acid, like the taste of sour apples, according to Devergie. *
– It is inodorous, volatilizes like metallic arsenic at a dull red heat, and, like the metal, crystallises in tetraedric needles.
– When thrown on burning embers, it develops a white smoke, having the odor of garlic.
– During this process the coal becomes decomposed and sets the metallic arsenic, to which this odor appertains, free ; for if, instead of throwing it on the burning embers, it is only placed in a crucible or on a red-hot metallic plate, the white smoke which rises from the plate volatilizes without being decomposed, and remains completely inodorous.
– Everybody is acquainted with the deleterious properties of arsenious acid, and the innumerable crimes which have been committed with arsenic, have excited prejudices against the therapeutic use of arsenic, which are far from being extinguished.
– The hydrated sesqui-oxyde of iron,* if administered in season, is the antidote of arsenic.
– I underline these words, if administered in season, for the iron preparations seem to act only chemically, as antidotes to arsenic, that is to say, by changing it to an insoluble arseniuret of iron ; whence it follows, that, if the sesqui-oxyde is not administered until the poison has been absorbed, the use of the iron becomes insufficient, and even entirely useless.
– In such cases experiments upon animals, which I made six or seven years ago, and which I have been unable to repeat since, for want of a suitable apartment, have shown me that the watery extract of opium, in massive doses, (from five to six centigrammes for middlesized dogs,) was the chief and best antidote of the arsenious acid.
– Unfortunately, I have not been able to confirm this observation by a single case of poisoning in man, but the fact seems, nevertheless, of interest to toxicologists.
– Empirical applications.
– The ancients do not seem to have known either the metallic arsenic or the arsenious acid.
– Orpiment or the yellow sulphuret of arsenic, and especially the realgar or the red sulphuret of arsenic, are, according to the statement of Harles, * the only arsenical preparations in use among the Greeks, or even the Arabs of the 10th century.
– Several passages in Rhazes of Avicenna, lead me to believe that the Arabs used principally, the realgar internally against cough and asthma, and orpiment externally (against the itch, tetters, and lepra).
– After having been abandoned almost entirely for several centuries, the arsenical preparations were again used externally by Theodore and Guy de Chanliac.
– The former used it in the treatment of scrofulous ulcers ; the latter, as an escharotic, to open hydrocleles. *
– At a later period the arsenical pastes were used for cancer ; this disease being such a frightful disorder, it was not deemed improper to combat it by the most desperate means.
– These preparations, although they have been of very little use, and have caused many accidents, are still used in our time.
– Some of them have enjoyed great celebrity, such as the paste of Rausselot, of the Friar Cosme, the powers of Justamond and Plukket, the pomatum of Hellmund, which was purchased by the Prussian government, and which does not differ essentially from that of Friar Cosme ; the anti-cancerous remedy of Davidian, that of Guy, of Chenet, etc.*
– But homoeopathy has nothing to do with these poor mystifications, which are but too often invented by quacks and by interested venders.
– According to Desgrages,* Linserbarht, better known under the name of Lentitius, and who practised medicine towards the end of the seventeenth century, was the first who employed the arsenious acid internally, at least, in intermittent fevers.
– But in order not to abbreviate our remarks concerning the use of arsenic in these fevers, by attaching ourselves to the chronological order, let us postpone this important subject for the present, and let us cast a rapid glance on the other diseases for which this drug was recommended.
– Cancer, cutaneous diseases, scrofula, syphilis, pulmonary phthisis, asthma, angina pectoris, various forms of periodical headache, facial neuralgia, rheumatism, chorea, and lastly, rage, these were the affections which empiricism, generally, when reduced to the last extremity, dared to combat with the white oxyde of arsenic.
– Success, was, however, far from crowning, in every instance, these bold attempts.
– But some cures were effected in these cases, which is sufficiently accounted for by the pathogenesis of arsenic.
– “For a long time past, physicians have tried to combat cancer by the internal administration of arsenical preparations.
– Zeller is one of the first who praised arsenious acid for such a diseases.
– Lefebure de St, Ildephont, Ronnow, Schmalz, Adair, Desgranges, etc., assure us to have seen good effects from it ; Dr. Minniks, of Philadelphia, says the same thing, etc.*
– Unfortunately, these are mere assertions supported by few facts, and of a doubtful authenticity.
– I do not think, however, that objections have been raised against the observations of either Ronnow or Minniks. *
– Even Thiebault, who is a zealous condemner of arsenic, takes care not to mention them in his answer to Desgranges, although this one alludes to both of them in his memoir.
– As regards the numerous cures which Lefebure, or rather, Lefebure de St. Ildephont boasts of having made with arsenic, I confess, that they seem to me rather doubtful.
– Even the title of his pamphlet published in 1774, would make me suspect them : Approved remedy for the radical cure of the hidden, open, or ulcerated cancer, etc.
– Approved by whom ?
– Of nobody but the author, as we learn from an official declaration of Missa, who was then royal censor. *
– Lefebre, therefore, deceived the public, and, on this account, does not deserve any confidence.
– But this is not all.
– The method which he points out in his pamphlet, had no success whatever in the hand of his warmest partisans.
– Desgranges, for instance, whom Merat and Delens mention by mistake as one of the physicians who had seen good effects from the use of arsenic in cancer, expresses himself in these terms :-“As soon as Lefebre’s pamphlet was published, we tried his remedy in the hospital of Lyons on several females affected with cancer at the breasts, groins, and uterus, following his prescriptions literally ; not one of these patients was benefited in the least ; all experienced anxiety in the praecordial region, spasms, pains in the stomach and bowels, and other kinds of distress, which induced us to abandon our experiments. *
– Metzger and Fodere were not any more fortunate.
– But ought we to infer from these failures that arsenious acid, if administered internally, and even after Lefebre’s method,* has never cured cancer ?
– Such is not my opinion, for negative facts do not invalidate facts that are positive.
– All that can be said is, that, as a general rule, these positive facts are exceedingly scarce in the annals of empiricism.
– Cutaneous disease.
– Here we have an abundance of facts, and if we had no other authorities to consult than modern alloeopathic physicians, their practice, except the doses, accords so perfectly with our own, that we might almost feel tempted to regard their mode of treating cutaneous diseases internally with arsenious acid, as copied from Hahnemann ; but I really believe this is not the case.
– For as early as 1789, Adair published the happy results which he had obtained with arsenious acid, taken internally, in obstinate tetters. *
– Rush, of Philadelphia, confirmed Adair’s observations about the same period.
– Lastly, in 1806, Girdlestone, but especially Willan and Pearson, in England, had popularized this use of arsenic by a number of successful cases, and Biett was one of the first who tried it in France.
– Cazenave expresses himself as follows concerning the use of arsenious acid in cutaneous disease : *
– “It is proven now-a-days, that wonderful results are obtained with arsenious acid in the treatment of cutaneous diseases, both in the dry forms and in the chronic eczema and intertrigo.
– This remedy in less successful in papulous eruptions, etc., and, in general, it has almost always failed in the various forms of porrigo, acne, sycosis, etc.
– It may be very useful in the elephantiasis of the Greeks ; to the treatment of acute exanthemata, it is not applicable, as a general rule.”
– Homoeopathy can add but little to these statements.
– Scrofula and syphilis.
– A pretty large number of wellauthenticated facts testify in favor of the efficacy of arsenic in certain forms of scrofulous ulcers.
– The observations of Physick, of Philadelphia, of Hans Roane, of Otto, concerning this subject, made a great nose among doctors at the period when they first appeared.
– Those which were published by Otto in 1805, in the Philadelphia Medical Museum, * are for us homoeopaths extremely characteristic.
– He speaks of malignant ulcers in the face, with caries of the bones and corrosion of the upper lip.
– So much for scrofula.
– As regards syphilis, the facts are less evident.
– But could it be otherwise ?
– The prejudice which has existed for upwards of two hundred years in favor of the absolute and exclusive specificity of mercury in venereal diseases, did not allow of the introduction of another anti-syphilitic which was not mercurial ; and yet it is well known that the famous anti-syphilitic decoction of Teltz enjoys even yet in England, and more particularly in India, a very extensive popularity ; and the active element of this decoction is a mixture of arsenic and antimony.
– Cullerier, a physician of our times, has even gone so far as to substitute a fixed dose of arsenic for this mixture, and has obtained the same favourable results.
– “In some venereal diseases, where mercury aggravates the syphilitic ulcers, Girdlestone arrests their progress with arsenical preparations.” *
– Boudin, whose writings we shall have to mention more extensively when speaking of intermittent fevers, entertains the same opinion as I do concerning the anti-syphilitic properties of arsenious acid.
– “Science,” says this author, “has a great many facts to show, where syphilis proved rebellious against mercury, and where the decoctions of Teltz and Arnould cured the disease as if by magic.
– As was remarked before, the influence of these preparations is principally due to the arsenic and antimony with which they are mixed.
– I am disposed to think, from some cases in my own practice, that arsenic may be a very useful remedy in constitutional syphilis.” *
– Pulmonary phthisis, asthma, neuralgia, etc.
– Although, according to Desgranges.
– Hippocrates, Galenus, and the Arabs, employed arsenical preparations for a cough with purulent expectoration, and notwithstanding a few dubious remarks by Girdlestone and Beddoes, I do not believe that pulmonary phthisis has ever been cured with arsenic.
– But I have not by any means the same doubts concerning the cure of angina pectoris, humid asthma, with periodical paroxysms of nocturanl suffocation and oedema of the lower extremities and face, or even ascites and general leucophlegmasia attributed to this drug.
– These cures are accounted for by the provings of Arsenic.
– The same is true in regard to certain cures of phthisis meseraica, facial neuralgia, periodical cephalalgia, (of which Fodere relates seven cases),* whooping-cough, trismus, epilepsy and various other nervous diseases, the observations concerning which are scattered through the works of authors.
– Hydrophobia even might perhaps be included among these latter disease, although it is generally treated with absurd means, or at a period when it has become impossible to cure it.
– In this respect we read in the dictionary of Merat and Delens : “Russel, in his work on the serpents of India, relates three experiments which he instituted, with varied success, with the pills of Tanjore, composed in a great measure of arsenious acid, on animals that had been bitten by poisonous serpents ; he says that he has given these pills with success to fourteen persons that had been bitten by mad dogs, but before hydrophobia had broken out.”
– J. P. Ireland employed arsenious acid in massive doses, in similar cases, with uniform success ; he relates five cases.
– In these cases, the acid brought about vomiting or stoo. *
– According to all probability, the acid, if employed in infinitesimal doses, would likewise have prevented the paroxysms of hydrophobia, and the patient would not have been disturbed with vomiting or diarrhoea.
– We shall have to refer again to this subject when speaking of Belladonna.
– It now remains for us to inquire as cursorily as may be into that property of the arsenious acid which is considered the most important by the regular physicians, and which is not even denied by such men as Stork, Didier, Peyrilhe, etc. ; who look upon arsenic as a poison that can only do harm, and should, on that account, be blotted out entirely from our materia medica.
– I mean the specific curative character of arsenic in fever and ague ; a question which has now been under discussion for upwards of a hundred and fifty years, and bids fair to be continued a good while longer by the orthodox members of the faculty.
– And yet the facts that testify to the curative character of arsenic in this disease, are almost innumerable.
– Indeed, from Rosinus Lentilius, whom we have mentioned already, or rather from Hadrien Stevogt * and Melchoir Frick * to Joseph Plenciz, * that is to say, from the end of the 17th to the end of the 18th century, arsenious acid was used in Germany all the time in intermittent fevers.
– The violence with which this heroic agent was assailed by its contemners, seems a guarantee for the enthusiasm with which it was defended by its friends.
– At the head of the former we have the celebrated Stork, who carried on this warfare with all the vehemence and bitterness which he afterwards displayed in his attacks on animal magnetism.
– But Keil, Bernhardt, the two Plenciz, etc., warm partisans of the arsenic, backed their arguments by thousands of cures against which the diatribes of Stork remained powerless.
– Even at the present moment a belief in the febrifuge properties of Arsenic has remained popular in Germany.*
– The use of arsenic in the treatment of intermittent fever was introduced in England by Fowler, in America, by Barton, in Italy, by Brera, and, in these different countries, it produced the same results which had been obtained in Germany for a century previous.
– But in France these decided successes were unable to conquer altogether the prejudice which this terrible name arsenic had excited among the people.
– Nothing short of the compete closure of the seas during the empire, was able to determine a few physicians to try arsenic as a substitute for Peruvian bark.
– Fodere, Lordat, C. L. Dufour, A. Boullier, J. C. Dupont, Desgranges, etc., were the principal authors of this innovation, which, in spite of its success, excited a good deal of oppositon. *
– Finally, as soon as the peace of 1815 had rendered to the French alloeopaths their bark, they speedily abandoned the arsenic, which was indeed completely forgotten until recently, when one of our army-physicians tried to restore its use.
– Boudin, physician-in-chief of the military hospital du Roule, is a distinguished thinker, well-informed, and in possession of that vast experience which a military physician is almost alone capable of acquiring, by studying the diseases in different countries and in different latitudes.
– I add that Boudin, if he was not an entire homoeopath, was very near becoming one in 1842, when, in his capacity of physician-in-chief of the hospital of Marseilles, he published his treatise on fevers.
– He has read Hahnemann, quotes him two or three times, and speaks of him with respect.
– If he does not accept his doctrine altogether, he uses at least some of Hahnemann’s proceedings.
– It is difficult to understand why Boudin, after having gone so far, should not have gone still farther, or should ever have endeavoured, as we shall see bye-and-bye, to retract himself.
– Be this as it may, I regard Boudin’s work as one of the best productions of modern alloeopathy, in point of though, originality and keenness of observation.
– Fe words have afforded me more pleasure, and excited a higher degree of interest in my mind.
– This monograph is distinguished from most other monographs in this, that the details which are sometimes as new as they are ingenious, are always governed by a truly generalizing mind.
– Boudin states and limits very clearly the question he desires to discuss : the marsh-intermittent miasm.
– According to him, the type, that is to say, the intermission, the remission, or the continuity of the febrile symptoms, does not constitute the characteristic manifestation of particular malady, nor even of a special class of diseases.
– Indeed a number of very different affections my likewise assume the intermittent type, in the same manner as a number of poisons may, according to Hahnemann, whose authority our author invokes, cause a series of intermittent symptoms.
– We may remark here in passing, that this sound observation shows how absurd it is on the part of our opponents, to treat all intermittent fevers with one and the same drug.
– This is the real cause of the want of success in the treatment of intermittent fevers with Peruvian bark, and of the cachexias which are developed almost every day by the injudicious use of this drug.
– In regard to marsh-intermittents, Boudin is of opinion that the phenomena of intermission, remission and continuity only express the different degrees of intensity with which the fever-miasm acts upon the organism.
– “If we consider attentively,” says be, “the manner in which the phenomena of marsh-intermittents develop themselves, either in different latitudes, or during the change of the seasons, or lastly at different degrees of elevation above the level of the soil, we would be struck with the relation which exists uniformly and strictly between the type of the disease and the intensity of the miasm, and which is so exactly proportionate that a progression in the quantity of miasmatic matter, arising from the focus of the disease, carries with it a corresponding increase of continuity in the type of fever.
– The tertian type, which prevails in the North of Europe, is replaced in warmer countries by the quotidian, remittent and even continuous type.
– On the other hand, as the heat increases, we see in the North of Africa a succession of types develop itself, which is analogous to the changes that take place in the type of the marsh-intermittents in proportion as we come nearer to the equator, so that the tertian winter-fevers of the North of Africa are gradually succeeded by quotidian, remittent, and even continuous fevers.” *
– This theory seems correct, and Boudin supports it by proofs which it seems difficult to gainsay.
– However, if it be true, as he says, that the tendency of the type to become continuous, is in exact proportion to the intensity of the miasm, how shall we account for the intermissions in cases of febris perniciosa, a malady which terminates fatally after the second or third paroxysm, unless it is arrested before ?
– The violence of the paroxysms is a sure sign of the intensity of the miasm.
– Why then are not such fevers continuous, more than any other ?
– Upon the whole, it cannot be denied, and Boudin himself will admit this, that, if the intermission of the paroxysms is not sufficient to characterize a disease, this strange and remarkable periodicity of the symptoms, does not, however, belong indiscriminately, and in the same degree, to all known maladies, no more than all drugs are equally capable of producing or arresting the intermittent disease.
– Would not arsenic, for instance, which is praised by Stevogt, Frick, Fowler, Pearson, Fodere, etc., as the greatest remedy for intermittent diseases, be one of those drugs or poisons, which, if taken in feeble doses, would produce effects that are characterized by the intermittent type, more than those of any other drug ?
– “I have seen,” says Boudin, “a quotidian intermittent fever, for which I had to give cinchona, develope itself in the case of one of my patients, who, in the space of twelve days, had taken twenty-four hundredths of a grain of arsenious acid for ichthyosis.
– Was this a simple coincidence ?
– I do not know ; the fact, however, is, that this patient, with the exception of his cutaneous disease, enjoyed the best health, and that his fever came on at a period when no other similar disease prevailed in town.” *
– This single fact proves nothing in the estimation of Boudin, and I understand the reason why.
– Biett, however, admits having observed similar phenomena in the hospital of St. Louis, and I have no doubt that, by ransacking authors, a number of other similar phenomena in the hospital of St. Louis, and I have no doubt that, by ransacking authors, a number of other similar facts might easily be obtained.
– If I am not mistaken, Morgagni mentions one or two cases of this kind.
– But what would be the use of such inquiries ?
– Boudin knows as well as I do, that all the symptoms of the marsh-intermittent fever, which he terms limnhemic fever or rather affection, from the simple diarrhoeic to the tetanic form, are contained in the pathogenesis of the white oxyde of arsenic by Hahnemann and his disciples.
– According to Boudin, every limnhemic affection, without distinction of type or development of its phenomena, arises from one and the same cause, but multiple in its unity, as we from one and the same cause, but multiple in its unity, as we shall see bye and bye namely, the effluvia of the marsh-vegetation.
– In this respect, our author believes, and I am disposed to share this belief, that it is not by the effluvia of stagnant water, nor by the emanations of decayed vegetable matter that the marsh-miasm is produced, but by the emanations arising from living plants.
– Some of these plants are already known.
– Such are among others, the anthoxanthum odoratum, which, according to Nepples, abounds in the marshes of the Bresse, where it goes by the name of flouve ; and lastly, according to Humboldt, the roots of the mangrove tree, and of the mancanilla, which, when not covered by water, are supposed by the inhabitants of India to be productive of fever.
– But how can we admit the identity of the marshmiasm, when the fever-engendering miasms vary so much among each other ?
– According to Boudin, the endemic intermittent fevers of the department of Aix in France, those of the North of Africa, of Morea, of Senegal, of the deltas of the Ganges, Nile and Mississippi, that is to say, the cholera, the plague, and the yellow fever, are forms of one and the same disease, or rather, different degrees of its intensity.
– “It is not only,” says he, “between the ordinary endemic diseases of marshy countries, that this identity exists, and I should not think having done more than to merely lift the veil under which the truth is hidden, if I contented myself with simply pointing out the identity that exists between the intermittent, remittent, continuous and masked intermittent fevers, and the endemic diarrhoeas and dysenteries of marshy regions.
– I have seen several times, in the North of Africa, the marsh-miasmatic diseases, not only simulate, but so faithfully express the cholera of India, that it was absolutely impossible to decide from the first, whether the disease was the real cholera or simply a sporadic cholera fever.
– In another case, which, it is true, is an isolated observation, I saw in the marshes of Navarin, in Morea, a febris icterica perniciosa, with vomiting of black matter, resembling tolerably well the yellow fever of the West-Indies.
– And in this same campaign of Greece, in 1828, I have observed among persons who had died with these severe marsh-intermittent fevers, an unusual swelling of the ganglions of the groin and neck, a symptom which greatly resembles a similar phenomenon in the disease of Constantinople and Alexandria.” *
– Independently of the symptomatic resemblance which is really remarkable in many cases, this author infers the identity of the nature of these diseases from two series of facts : 1st.
– From a sort of antagonism which all these diseases exhibit in regard to such affections as pulmonary phthisis and typhus, and which antagonism is so decide, that these different classes of diseases never co-exist in the same locality ; 2d.
– From the fact that they are all cured by the same drug, Which is arsenious acid.
– Omitting this question of antagonism, however interesting it may be,* I hasten to admit with Boudin the efficacy of arsenious acid in all the diseases mentioned by him, or rather, I rejoice to think that the admits it with me ; for I do not think that alloeopathy cab claim as its practice the use of arsenic in vomiting, diarrhoea, cramps, and other symptoms of cholera ; but is this efficacy, as our author seems to think, an irrefragable proof of the identity of these diseases ?
– To ad same drug is not able to cure two apparently different diseases : an untenable hypothesis which is contradicted by thousands of facts.
– Upon the whole, I suppose that it is with the marsh-miasm as with psora ; as I said above, it is at the same time one and yet multiple.
– But what would be of the highest interest to in my estimation, would be to determine, by inquiries made in the different localities where marsh-intermittents are endemic, to what kind of marsh vegetation such and such a form of marsh-intermittent corresponds most generally if not specially.
– As we said above, Boudin treats almost all limnhemic affections, without regard to symptoms, by arsenious acid ; and, in this respect, his practice is, in almost every case, perfectly conformable to the demands of homoeopathy.
– This will be admitted by any one who has observed the various morbid manifestations of the marsh-miasm, and who, like Boudin, has studied Hahnemann’s pathogenesis of arsenious acid.
– The physician-in-chief of the hospital of Marseilles is, therefore, knowingly a homoeopath, so far at least as the treatment of limnhemic affections with arsenic is concerned ; and all that seems left for settlement between him and us, seems the dose.
– The following passage bears upon this point : “After commencing in my experiments, with one twenty-fourth part of a grain, I gradually became convinced, together with a number of other physicians who obtained results perfectly similar to my own, that arsenious acid, if suitably prepared, preserves even at the small dose of non-hundredth part of a grain, all its medicinal every, not only in the treatment of marsh-intermittents, but also in that of a number of other diseases.
– With a single dose of one-hundredth part of a grain, all its medicinal energy, not only in the treatment of marsh-intermittents, but also in that of a number of other disease.
– With a single dose of the one-hundredth part of a grain, I have often removed radically fevers that had been contracted in Algiers or on the Senegal, and which had resisted any kind of treatment, even the sulphate of quinine and a change of climate.” *
– But this is not all
– What vehicle would you think Boudin uses for the administration of his almost infinitesimal doses of arsenic ? distilled water, which is used for all mineral preparations, and which is particularly adapted to the white oxyde of arsenic, which is almost tasteless and dissolves in this liquid ?
– Not at all ; like Hahnemann, Boudin prefers the sugar of milk to distilled water.
– It is true he allows every dose to be dissolved in water, but he directs, like Hahnemann, that the arsenic and the sugar should be previously triturated for a time.
– Here is his formula :
– R Arsenious acid-one centigramme, (1/5 of a grain).
– Add gradually, in small quantities :
– Pulverized sugar of milk-one gramme, (20 grains).
– Triturate in a glass mortar for a sufficient length of time (at least 10 minutes) to mix these substances well together, and divide the whole into 20 packages, each containing one-half a milligramme, or the 1/100 of a grin of arsenious acid.
– “This preparation,” says the author, “is the one which I use most frequently ; a package is dosslved in a spoonful of water, and the solution taken five or six hours before the time when the paroxysm is expected to set in.
– “This formula is likewise applicable in obstinate cutaneous affections, and in inveterate syphilis.” *
– The following list shows that, in spite of the smallness of the doses, Boudin’s results, which he obtained in 1842, were at least as satisfactory as those which had been obtained formerly with much larger doses by Fowler,* Fodere, Lordat, etc. :
– DISEASES which has not been Resisting the bark, Resisting the arsenic, Resisting both bark TOTAL previously treated with any and cured with arsenic and cured with bark and the arsenic other medicine Quotidian fevers, 102 19 4 3 128Tertian fevers, 53 11 3 0 67Quartan fevers, 2 4 1 2 9Quintan fevers, 1 2 0 0 3Irregular fevers, 18 13 2 2 35Fevers called masked 12 8 1 1 24Total of Results 118 57 13 8 266
– Thus then, in 266 cases of intermittent fever, of various forms and types, the arsenious acid, administered only one the days of the paroxysms, and omitted during the apyrexia, (this was Boudin’s method,) failed only in twenty-one cases, although it was only given in doses of 1/100 of a grain.
– In these twenty-one cases, however, quinine was not more fortunate than arsenic.
– What is to be inferred from this fact ?
– This truth, which homoeopathic physicians should well bear in mind, that there is no absolute specific, and that thee may even be cases of marsh intermittent which may resist both arsenic and quinine, and which the peculiar constitution, temperament, or idiosyncratic conditions of the patient may require to be treated with some other drug.
– But if the arsenic is not always a specific for fevers which we know positively to have been induced by marshy effluvia, its specific character becomes still more doubtful in cases of unknown origin, existing at a distance from the focus of the marsh-epidemic, and having nothing in common with this latter disease than a small number of symptoms and the intermission of the paroxysms.
– Every homoeopath knows that, in such a case, some fifteen or twenty drugs claim his attention as much as arsenic.
– Can it be, perhaps, considerations of this kind which have induced Boudin to modify his original treatment of intermittent fevers, and not to prescribe the arsenic until the patient has been previously vomited with a dose of ipecac, or stibium, and to give five or six grains a day ?
– According to the last edition of the traite de therapeutique, by Trousseau and Pidoux, Vol. I., p. 261, the present method of the physician in chief of the hospital du Roule, is as follows :-
– First rule.
– Commence the treatment with an emetic, (ipecacuanha one gramme ; stibium one decigram,) if the fever is accompanied with gastric symptoms, suppression or diminution of the appetite.
– After the fever has been arrested, give another emetic, provided the appetite is not entirely restored ; in order to allow the patient to use as soon as possible a substantial and generous diet.
– Second rule.
– Give arsenious acid in fractional doses, that is to say, one dose divided into several, the last dose to be given at least two hours before the time when the paroxysm is expected to come on ; proportion the dose according to the character of the fever, which varies according to locality, season, and the individuality of the patient.
– Give the arsenious acid according to tolerance, so as to gradually arrive at the largest possible dose, giving every quarter of an hour one milligramme, or only half a milligramme, (one gramme or half a gramme of the solution.)*
– As the patient bears less of the arsenic, diminish the dose gradually, and continue the fractional mode of administration ; if necessary, give the drug partially or totally by the rectum.
– Take the drug both on the days of the paroxysms and during the apyrexia.
– Continue it during an interval proportionate to the duration of the disease, and to its resistance to other and previously instituted mode of treatment.
– In a first attack of a disease, the drug should be continued at least for a week after the last paroxysm, ect.
– Third rule.
– Use a substantial and abundant diet, to be limited by the appetite and the digestive powers of the patient.
– The diet to consist principally of beef, roast mutton ; a generous wine to be ordered, in quantities proportionate to the weakened state of the constitution of the patient ; watery beverages to be avoided as much as possible.
– All this is very different, as is seen, from Boudin’s former practice.
– I confess I am unable to say how far his present method is superior to his former mode of treatment.
– Does every case of intermittent fever yield to grain doses of arsenic, even such cases as proved refractory to the 1/100 part of a grain ?
– I can scarcely believe it ; or is it, according to Trousseau and Pidoux, because this mode of treatment does away with the necessity of using quinine ?
– If this be so, is the complete abolition of the use of quinine a rational proceeding ?
– Upon the whole, what seems to me to result most clearly from this new method of Boudin, is, first, that by means of certain accessory medicinal agents, and of certain hygienic combinations, we succeed in enabling patients to bear truly poisonous doses of arsenious acid ; secondly, that this tolerance, all other things being equal, is proportionate to the intensity of the disease ; this, however, is nothing new either to homoeopaths or to the partisans of counter-stimulation.
– Who does not know that as many as twelve grains of the extract of opium have been given in delirium tremens, and as many as one hundred gains of stibium in pneumonia
– Be this as it may, I will endeavour to account for this tolerance of the massive doses of arsenious acid in Boudin’s treatment.
– As we said, in speaking of the analogies of mercury, to which the arsenious acid belongs, (see page 99,) this substance is essentially depressing in its general action upon the general organism.
– Hence strong constitutions resist its action much better than constitutions that are naturally feeble and of a lower order of vitality, without however being sick ; for, in such a case, the conditions of the problem might be completely changed.
– This is the reason why herbivorous animals, such as rabbits, chickens, etc., are readily killed by small doses of arsenic, and carnivorous animals bear, on the contrary, enormous quantities of the poison ; one ounce of arsenic, which rebalancing gave to a bear, had no other effect on the animal than to purge it ; and, in the East of France, our peasants know perfectly well that arsenic will not destroy wolves, and other dangerous or hurtful carnivorous beasts ; for, it was in vain that whole pounds of arsenic were stuffed into pieces of meat, and left on the snow, along the edges o the woods, or in the midst of the thickets inhabited by these animals.
– But, it may be replied, these facts simply point to a general law that has been known for a long time past.
– Who does not know that lions, tigers, and wolves, have a more tenacious life than horses, rabbits, and hens ?
– It is not, therefore, to be wondered that these weaker animals are less capable than the former, of resisting the action of arsenic.
– I answer ; if it be true that carnivorous animals resist destructive agents much better than herbivorous or granivorous animals ; thee are however, some poisons, as we said page 55, which are an exception to this rue, and act more powerfully on carnivorous than on herbivorous animals.
– This is not an empty speculation ; the nux vomica will be sufficient, hereafter, to demonstrate the truth of my remark.
– If now we consider that, in all animals, and also in man, who, as respects his physical organization, is at the same time a carnivorous and herbivorous animal, the destructive action of arsenious acid, is inversely proportionate to the degree of vitality possessed by each animal ; if we consider, moreover, that this vitality depends in a great measure upon the kind of diet pursued by each species and individual, we cannot fail to comprehend how Boudin’s patients find in the exclusively animal diet which he prescribes for them, a sort of immunity against the excessive doses of arsenious acid used in the treatment of their disease.
– Besides, ipecacuanha and stibium, (especially the former, as is well known by all homoeopathic physicians,) neutralize in a measure the effects of arsenic ; hence it follows, that Boudin administers the poison with one hand, and with the other the antidote.
– If his patients improve under this method, I have nothing to say against it, for the tree medicine is that which cures.
– I confess, however, that, until I am further enlightened, I shall believe that Boudin was bearer the truth in 1842, than he now is.
– If we will now take the trouble to reflect on what has been said, we shall obtain an explanation of a series of truths which the homoeopathic applications of arsenic confirm every day.
– Thus :
– 1. Arsenic being capable of producing in a healthy person, the general depression of the vitality, (cacohymia) which the constant and exclusive use of a vegetable diet, (especially when consisting of herbs and watery fruits) almost always, occasions, it follows, by virtue of the law of similitude, that arsenic, which is a most violent poison for individuals impoverished by a low diet, is, on the other hand, most admirably adapted to their constitutions and a majority of their maladies, if given in infinitesimal doses.*
– 2. Arsenic is essentially, and in almost every person, adapted to acute diseases, (Indigestions, etc.) accidentally occasioned by the excessive use f herbaceous food, (melons, strawberries, fruits in general, but more particularly watery fruits.)
– The diseases which arise from the abuse of vegetables, and those which are occasioned by arsenious acid, are in every respect, indentical in form.
– 8. Lastly, arsenic seems to be, in the majority of cases, the specific remedy of sporadic or epidemic diseases, caused by vegetable emanations.
– It is to be remarked, that, in the very acute diseases which belong to this category, the cholera, yellow fever, the febris perniciosa and the plague, the patient, whatever be his constitution, seems to sink in a few hours in the lowest state of cacochymia, such as our marsh-effluvia only produce slowly, after a long lapse of time, and then only incompletely.
– However, these are very general, and very ague considerations concerning the therapeutic virtues of arsenious acid.
– We have to study the pathogenesis of this drug, in order to obtain a knowledge of the manifold applications of which it is capable in the treatment of disease.*
– Homoeopathic applications.
– The dynamised arsenious acid has been found useful in the following affections :- Affections of persons excesses or a bad diet, of a lymphatico-nervous constitution, irritable, disposed to sadness, to mucous discharges, to dropsy and tetter ; endemic affections which prevail among the inhabitants of low and marshy districts ; cachexias occasioned by abuse of mercury, iodine, and especially quinine ; partial or general atrophy ; constitutional syphilis ; pale bloating and softening of the tissues ; glandular engorgements ; paroxysms of fever, neuralgia or general weakness returning at fixed hours of days ; paroxysms of anxiety at night, compelling one to rise from bed ; shuddering in the evening, with pandiculation and agitation ; aggravation of the pains during rest ; bone-pains ; aggravation of the pains, when lying on the affected parts ; pains which are felt during sleep ; hypochondriac mood ; compunctions of conscience, as if one had committed a bad deed ; periodical paroxysms of hysteria, epilepsy, and paralysis ; weakness of the memory and of the other intellectual faculties ; passing excitability, followed by weakness of the senses ; mental derangement, with tears and ominous wanderings and expressions ; furious delirium ; with desire to bite, as in hydrophobia ; earthy, blueish, cadaverous color of the skin ; burning itching, which is intolerable, and is not appeased by scratching ; sanguinolent pemphigus ; malignant variola ; eruption consisting of red, pimples, which break and form spreading ulcers ; chronic impetigo and eczema ; elephantiasis of the Greeks ; ulcers with raised ad callous borders, surrounded with a red and shining areola, lardaceous or blackish bottom, and a burning pain which is eased by warmth and aggravated by cold ; ichorous and fetid suppuration of the ulcers ; suppression of all suppuration, with aggravation of the pain ; stupefying, pressive, pulsative headache ; vertigo even to falling, especially in the evening, when sitting or rather, on rising after having been sitting for a time ; excessively painful hemicrania, in paroxysms, with viscid sweat and icy coldness of the hairy scalp, and a violent itching after every paroxysm ; ulcerations at the hairy scalp ; falling out of the hair and beard ; swelling of the head, face and neck, sometimes enormous ; inflammation of the eyes, with photophobia ; wrenching pain in the bottom of the orbits, which is sometimes frightful ; protrusion of the balls of the eyes, and profuse discharge, even in complete darkness, of corrosive tears ; icy coldness at the eyes during the paroxysms of pains ; contraction of the pupils ; muscae volitantes ; congestion and hypertrophy of the vessels of the cornea, whence arises the phenomenon of a blackish or whitish gauze, which intercepts the visual ray ; amaurosis ; oedematous swelling ; excessive dryness or continual trembling of the eyelids ; noise in the ears ; otalgia, weakness of hearing ; hippocratic face ; pullings and stitches in the face here and there ; dull pain in the nasal bones ; red tetters on the forehead and cheeks ; acne rosacea ; chapping and swelling of the lips ;bleeding of the gums ; dry mouth, or else filled with a viscous, bitter, sometimes bloody saliva ; wrenching toothache, worse in the cold ; looseness and falling out of the teeth ; foul smell from the mouth ; taste as of foul flesh in the month and throat ; aphthae in the mouth ; tongue coated, cracked, ulcerated, brownish, blackish, tremulous ; scratching in the throat between the acts of swallowing ; sort of paralysis of the pharynx and oesophagus, which renders deglutition almost impossible ; gangrenous angina ; aversion to cooked food ; desire for milk, fruits and coffee ; habitual difficulty of digesting vegetables and milk, which cause acidity and flatulence ; burning thirst, or rather, constant desire to nourishing the mouth and throat with a cold liquid ; periodical paroxysms of bulimy ; hiccough and sour or putrid eructations after every meal ; nausea with flow of water from the mouth, after every meal ; indigestion caused by fruits or milk ; violent vomiting of brownish substances ; excessively acute gastritis ; yellow fever ; sporadic and Asiatic cholera ; chronic disposition to nausea and vomiting ; subacute gastritis occasioned by a metallic body in the stomach ; heaviness at the stomach ; burning pain in the stomach, and epigastrium, pyrosis ; distension and excessive sensitiveness of the epigastric region, with anxiety and a feeling of embarrassment in the praecordia, as if the heart would be crushed ; tetters at the epigastrium ; induration of the liver ; heat in the bowels ; excessive bellyache, especially on the left side ; flatulence having a putrid smell ; pain in the abdomen, as from a sore or burn ; cold and viscous sweat on the abdomen ; ulcer at the umbilicus ascites ; smarting stools, with violent colic ; green diarrhoeic stools lienteria ; dysentery ; constipation ; painful prolapsus of the rectum ; ascarides ; burning piles ; swelling of the groins ; paralysis of the bladder ; difficulty of urinating ; strangury ; swelling of the genital organs; gangrene of chimney-sweep ; momentary excitement of the sexual desire, followed by impotence ; lascivious excitement in women ; premature, pale, profuse menses, which last too long ; dysmenorrhoea ; amenorrhoea, with acrid discharge from the vagina.
– Stoppage of the nostrils ; violent coryza ; dryness and burning at the larynx ; blood-spitting ; paroxysms of suffocation, in the evening after lying down ; oppression on the chest when going up hill ; whooping-cough ; angina pectoris ; stitches in the sternum ; pressure at the sternum ; pulling and tearing pains from the elbow to the axilla, at night ; tearings and pullings in the hip, thigh and groin ; cramps in the thigh ; sciatica ; tearing in the tibia ; contusive pain in the knee-joint ; itching tetters at the bend of the knee, old ulcers on the legs causing heat and stitches ; weariness in the legs ; varices ; spreading ulcers on the soles of the feet, and at the big toes ; smarting pain at the toes when walking.
– The symptoms caused by arsenic seem to assume a nervous form the higher the attenuations with which the provings were instituted.
– Thence it follows that the lower attenuations of arsenic are more particularly adapted to organic affections, and especially to the very acute affections of the bowels.
– We know indeed from experience that the 12th dilution of arsenic was much more efficacious in cholera than the 30th ; having had an attack of the cholera in 1849, I have very accurately observed the differences on my own person.
– Ipecac., veratr. alb., China, Nux vom., and especially Camph., are, according as such or such symptoms predominate, the best antidotes to arsenic.