D . M.

Cuprum metallicum, a study G I B S O N , M.B., B.S.(LOND.), F.R.C.S.(EDIN.), r.F.HOM.

PIIARI~IACOGN O S Y

The metal copper gets its name from Cyprus, the island sacred to Venus. Its ores manifest an amazing range of vivid colours, blues, greens, reds, purples. The metal itself when burnished glows like gold. It burns with a shining blue-green flame tinged at the tip with red. I t is a very active metal with a great capacity for absorbing water and transforming it into form and colour.

Next to iron, copper is perhaps the most useful metal in the world. Millions of miles of copper wire and cable carry the electric current that drives motors and transmits messages from one end of the earth to the other. Alloyed with zinc the metal forms brass, which has a thousand uses from curtain rails to cartridge cases. Alloyed with tin it forms bronze. Copper was indeed the first metal used by man as he emerged from the Stone Age.

Copper is an essential constituent of the body, but in trace quantities. Poisoning hazards may, however, derive from copper contamination of fumes, dust or air in connection with smelting, from the use of the metal in welding, in the preparation of alloys, in the electrical and building industries, in the manu- facture of inks, paints, and agricultural products such as fungicides and pesticides.

For use as a remedy triturations are made of dry powdered copper up to the third centesimal potency, when it becomes soluble in water or alcohol. Further potencies are then prepared by succussion.

PHAI~IVlAC 0L 0 GY

The metal acts as an irritant throughout the whole length of the intestinal tract, causing severe nausea, burning, vomiting and purging. Affinity with the nervous system produces first spasms and convulsions, and later paralysis. Copper dust if inhaled involves the lining of the air passages, resulting in laryngitis, bronchitis and, possibly, asthma.

PHYSIOGNOMY

The face tends to be reddish or red and white in patches. Jerking occurs in the limbs, starting in toes and fingers. In the presence of convulsions the lips and limbs acquire a bluish tinge. A characteristic feature is forcible flexion of the thumbs into the palms. Eyelids may show snapping movements. Speech may be impaired and stammering, owing to partial paralysis of the

tongue. There are long pauses before replying.

PSYCHOLOGY

Emotional instability is prominent; flies off the handle; moods vary--sullen, loquacious, malicious, morose, often with fixed ideas, possibly a terror of death.

The spoiled child, tricky, changeable, disorderly, dissatisfied. Sudden urge to

CUPRU1M[ I ~ I E T A L L I C U M , A S T U D Y 239

injure, to scream, to run away, to escape. Tendency to shrink from people; aptitude for mimicry.

Wild-eyed, maniacal fits of rage; or may lie like one dead, blue and rigid.

P H Y S I O L O G Y

Is excessively chilly, yet thirsty for cold water. Gluttony may alternate with anorexia.

Sleep is deep; twitching and jerking occur in sleep with audible borborygmi. Sweats occur at night and are profuse.

Modalities. There is aggravation from cold air, cold wind; from touch or pressure; before the menstrual period; in evening and at night; at New Moon.

Curiously enough is better by taking cold drinks, and sweats also give relief.

P A T H O L O G Y

General. Violence characterizes all symptoms. Paroxysms of cramp or actual convulsions recur at intervals and are followed by extreme mental and physical exhaustion.

Spasms can be triggered off by vexation or fright, or are associated with uraemia or other form of toxaemia, resulting perhaps from suppressed eruptions.

Nervous prostration affects young people. Exhaustion may derive from loss of sleep or be brought on by undue effort, either mental or physical.

Onset and cessation of the cramps are both abrupt. Periodicity is a feature, and symptoms tend to be left-sided.

Head. Severe headache is accompanied by spasmodic vomiting of all food and fluids ingested. Throbbing headache occurs in the region of the frontal sinuses; some relief is obtained by lying down with the head warmly wrapped.

Giddiness accompanies various ailments, with a tendency for the head to fall forward on the chest.

There may be a feeling as if cold water was being poured onto the head.

Eyes. Snapping of lids has been mentioned. There may be rapid rotation of the eyeballs.

Inflammation may occur in the orbital tissues or in the lachrymal gland. Violent itching in eyes towards evening. A bruised pain is felt in the orbit on

moving the eye.

Ears. There is mention of itching in ears; of something hard pressing on the ear; boring pain in and behind the ear.

Respiratory system. Throat feels very dry, accompanying violent thirst. Voice persistently hoarse.

A dry cough, paroxysmal in type, is associated with redness or cyanosis of face; is often worse from 23 hours to 1 a.m. The cough, which may have a gurgling sound, is aggravated by contact with cold air, but relieved by taking a drink of cold water.

Whooping cough results in a cataleptic state--face blue, finger nails dis- coloured, eyes turned up, apnoea and insensibility, till it seems the child will never breathe again. Cold water relieves the spasm.

2 4 0 T H E B R I T I S H I { O M G ~ O P A T H I C J O U R N A L

Frightful asthmatic attacks cause the sufferer to clutch frantically at the air, totally unable to speak or swallow.

In pneumonia sudden suffocative attacks occur, with coldness of surface, great prostration and cold clammy sweat.

Acute constriction may be felt in the region of the xiphisternum; possibly a sensation as if transfixed with a knife or as if a lump in that spot was squeezing the life out of him and he must die. Any serious interference with respiration, the basis of life, is likely to be accompanied by a fear of impending dissolution.

Alimentary system. Saliva is thick and sticky. A peculiar metallic taste may be noticed in the mouth. The tongue is pale, moist, paralytic.

The gums may be ulcerated, with a dark green or purple line at the tooth margin.

Dysphagia occurs from spasm of the oesophagus, accompanied by a gurgling sound when swallowing.

Nausea and anorexia of nervous origin may be severe. Abdomen is tender, stony hard, hot and very sensitive to touch. Horrible

colic may be present, associated with hiccough. Colic is relieved immediately after passage of stool.

Diarrhoea is profuse, violent, painful, associated with cramps and frequent urge to stool.

Cholera calling for the remedy is accompanied by very severe cramps and the stools are fluid, green and contain blood. I f icy coldness and dryness are the prominent features Camphor is indicated; copious sweating, purging and vomiting call for Veratrum album.

Intractable vomiting may be relieved by a drink of cold water.

Cardiovascular system. The remedy may be indicated in angina pectoris. Pulse is changeable, small, soft.

Urinary system. Urgency of urination with scanty amount passed. Scalding shooting pain in urethra during and after urination. Nocturnal enuresis.

Genital system. Crampy dysmenorrhoea before or during menstrual period. Cramps may also be associated with amenorrhoea.

Convulsions accompany eclampsia or occur in the puerperium, often preceded by loss of vision.

Nervous system. In a typical epileptic seizure the subject falls with a shriek, jaws are clenched, face distorted, eyes turned upwards, lips blue, thumbs acutely flexed in clenched fists and surface of body covered in cold sweat. At the same time there is incontinence of both urine and faeces. The attacks occur often at night or at the time of the New Moon and tend to recur at regular intervals, possibly at the menstrual period.

Locomotor system. Cramp is a prominent feature, especially at night, forcing the subject to get out of bed and walk up and down for relief.

Skin. Dry itching eruptions occur, such as psoriasis. Tetters with yellow scabs may be located at the flexures of joints. Itching is aggravated by heat and is worse at night in bed. Miliary rashes may also occur.

C I C U T A V I R O S A , A S T U D Y 241

P O S O L O G Y

Lesions accompanied by cramp or convulsion provide the main indications for the remedy. I t has been found of value in meningitis. Calcium carbonicum is a complementary remedy.

D .

Cicuta virosa, a study M. G I B S O N , M.B., B . S . ( L O ~ D . ) , F . R . C . S . ( E D I N . ) , F.F.HOM.

P H A R M A C O G N O S Y

Cicuta virosa is one of the most poisonous of the enormous Umbelliferae family; it is especially lethal to horses and cattle, hence its name cowbane.

In appearance it resembles Conium, but its stem lacks the red blotches characteristic of Conium maeulatum, the common hemlock. Cieuta is also known as water hemlock from its habitat; it is found growing on river banks, in muddy ditches, in swamps, on moist moors, at the edge of lakes or ponds. I t occurs in temperate regions of the northern hemisphere.

The hollow, furrowed stem may attain a height of four feet, and has often a reddish tinge. The small white flowers are arranged in large many-rayed compound umbels; the umbellules are marked by an involucrum of small pointed bracts. The fleshy root is hollow, divided into cells by transverse partitions; it is white in colour, but exudes a yellow juice if cut into. The leaves are pennate with long stalks, the leaflets being deeply serrated and bright green in colour. The laterally compressed fruit shows five not very well marked ridges.

The root is highly poisonous, containing a soft insoluble resin in which are present the poison cicutoxin and an alkaloid, cicutine. The Mother Tincture is prepared from the fresh root, gathered at the beginning of flowering.

The whole plant has an odour similar to tha t of parsley. The root has a resemblance to parsnip; fatalities have occurred as the result of the root being eaten in mistake. Symptoms of poisoning include dizziness, drowsiness, stupor with dilated pupils; epileptiform convulsions; severe burning pain in mouth and stomach with unquenchable thirst, paralysis of tongue and dysphagia. Death is preceded by acute dyspnoea.

PHARMACOLOGY

The main affinity is with the nervous system, inducing extreme sensitivity of nerve endings in muscles, with resultant liability to spams and convulsions, both clonic and tonic. Involvement of the brain causes first excitement, then coma. Local effects on the alimentary t ract cause burning and nausea. Action on the skin tends to produce a pustular type of eruption.