Dr.B.S.Suvarna
Carboveg on the other hand is principally indicated in states of advanced collapse where we know the prostration algidity and cyanosis are extreme .the pulse is filiform or nearly imperceptible and the body is bathed with a glacial clammy sweat. In all conditions of extreme adynamia with defective hematosis and prevailing torpor of all the functions no remedy can replace this drug to arouse the system from the utter prostration often observed in infections diseases of serious character and consequently it becomes our anchor of salvation in many cases of typhoid ,yellow or septic fever in which the lowering of the forces and collapse suddenly supervene . carboveg seems to have marked affinity for the abdominal viscera ,and is not less efficacious in respiratory troubles (emphysema, bronchiectasis, bronchorrhea) which are accompanied by a progressive flagging of the powers , cyanosis, circulatory failure paroxysmal dyspnea and reactionary torpors especially in brokendown constitutions or in the aged with bronchial dilatation. In the typhoid state ,which sometimes supervenes during the course of law infectious fevers of a malignant character ,or the result of auto infection ,we have also phosphoric acid and muriatic acid which though in a lesser degree than carboveg have the power to urge the depressed forces of the organism and bring about reaction .In phosphoric acid the sinking of the forces and exhaustion are not as profound as in carboveg but the sensorial depression is intense the patient is sunk in a state of stupid apathy if insensible to all external impressions ,but reacts momentarily under the influence of active urging to fall readily back to his previous stupour .it seems as if the reactionary powers were sufficient to spur but not operate a complete reaction .under this drug the visual and auditory centers are deeply affected and the spoor is attended by a muttering delirium .
Muriatic acid is as depressing as carboveg for in both the functional torpor , exhaustion and collapse are extreme .the former however ,exhibits in its decubitus certain degree of erethism not to be found in the latter ,which corresponds to the most perfect type of stupor and collapse and where the disturbance of the cerebral cortex reaches its highest degree of intensty ,as evinced by the cerebral cortex reaches its highest degree of intensity as evinced by the almost complete loss of conciousness.
Frinks considers muriatic acid applicable to erethistic conditions too severe for bryonia too asthenic for ‘rhustox’ and not cerebral enough for ‘belladonna’ but after ‘carboveg’ I reckon ‘muriatic acid ‘the most asthenic and among the ataxo-adynamic ,the one most depressing to the nervous centers.
Its dorsal decubitus as said above ,exhibits not withstanding the adynamia and stupor a certain amount of irritability but in a more inferior grade than in either ‘rhustox’ or ‘arsenicum’. Its prostration amounts to paresis with privation of the senses and motion is limited to a sliding down of the body towards the foot of the bed in which of course the will does not intervene in the least ,so extreme is the state of physical and moral impotency .putridity together with the disorders of motions and sensation reveal an intense gravity and are the leading charecterstics of this remedy.
‘Helleborus niger’ is another important remedy .comparable with ‘muriatic acid’.it is also indicated in the most severe adynamic conditions with lack of reaction specially in those cases in which the centres are so perverted that they do not seem to respond to any stimulus .
The privation of the senses ,the abolition of the will are complete ;the look is vague ,the expression stupid ,the pupils dilated ,the nostrils are sooty the pulse nearly imperceptible ,the muscles convolsed,the urine retained andcrushed down by toxemia ,the body as in ‘muriatic acid’ slides to the foot of the bed ,incapable of the least effort to change the distressing position .the suppression of the urine has been my prctice but I shall always consider it inferior to carbo veg to urge the nearly extinguished powes of the system.
Other varieties of functional torpor ,daily met with in practice ,may ciaim the employment of other remedies. For instance ‘hyoscyamus, whose pathogenesis plainly reveals its ataxo-adynamic’ power ,especially when the lack of co-ordination translates itself by psychometer impulses of an impudic and lascivious character.
In two cases of ataxo-adynamic typhoid ,with manifestations of erotic irritability ,this remedy in my hand ,brought about prompt reaction.the asthenic deilirium ,with its vivid imaginations and illusions, the consulsive motion and torpor of the entire organism ,have lead to its employment in cerebral typhus.
In the retention or even suppression of urine of low adynamic states it shares honors with HELLEBORUS .the loss of conciousness and of the functions of the special.
Senses sometimes complete;at other times yhe functional torpor is atrended by extoic exhibitions of extravagant affections for the opposite sex or by displays of unchaste and lascivious acts (emotional insanity) .
In the typhoid state ,calling for hyosyamus .the patient ,like in “phosphoric acid”lies in the supine position in profound stupor ,as if the intillegence and sensibility were suppressed ,but momentarily reacts when called or spoken to fall back again in to his previous state of stupor.another important indication of this drug is the state of irritability or hyperesthesia of the motor nerves as shown by the conclusive movement of the limbs ,the substatus tendinum the agitation of the hands and feet ,which supervine in the midst of the most extreme prostration ,a state which corresponds with the sensorial excitement (insomnia,delirium,mania) and which contrasts ,with the depression of the cerebral cortex (partial or complete loss of concioussness) it is like wise indicated when the visual and auditory centers are affected(dimness,of sight contraction of the pupils optical illusions ,tinnitus auricum ,deafnes)
It completes with LACHESIS and HYDROCYANIC ACID in the syncopal state which is a collapse of lesser intensity .
HYDROCYANIC ACID like LAUROCERASUS contains prussic acid, and both have been employed with grcetfying results not only in cardiac syncope ,but in the threatening asphyxia of capillary bronchitis and other pulmonary affections .
The rapid sinking of therces with long lasting faints and lack of energy or vital reacton is its leading charecterstics particularly so in pulmonary or cardiac troubles when the respiratory centre in the medulla becomes debilated and the motor nerves are almost paralyzed, it’s action upon the blood and heart makes it further applicable to serious cases of typhoid fever and cholera asiatica .In cholera asiatica ,it should be studied when anguish and dyspnea prevail ;the drinks pass with a gurgling sound dyspnea and cramps cease the vomiting diminishes ,the urine urine is suppressed and and a glacial coldness with gradual extinction of the pulse ,complete the dangerouspicture .
When the urine is suppressed ,hydrocyanic acid compares favourably with “opium’ “cammphora’and ‘helleborus’’ it has aiso given good results in many suufocative attacks of laryngeal phthisis when asphyxia seemed impending in a case of diaphragmatic paralysis.,alter diptheria a few doses of the 3c scafficed me to bring about an incontestable recovery.
In’ lachesis’ we have another,therapeutic agent of considerable efficacy again those typhid and asystolic conditions characterized by paroxysms of dyspnea and syncope. The lowering of the vital forces comes on suddenly .there is loss of sensibility and motion , the face is pale and sunken, the body is bathed in cold sweat ,the pulse is intermittent , tremulous , almost imperceptible and there is lack of reaction.
Invalvular disease of the heart with errtic palpitations,stiching pain ,anxiety ,dyspnea fainting spells and cold sweat ,it has been productive of good results and the same may be said ,in those attcks of cardiac asthama ,so full of distress inquietude and apprehension and which are always aggravated by lying down.
It has also been employed with success in abdominal disease appendicitis ,septic peritonist ,infections salpingitis etc..with prevailing dyspnea and syncope in which there is an fxtreme sensitiveness to touch ,the prostration of lachesis is not attended by the vascular and nervous erethism of arsenicum ,nor the death-like asthenia’carboveg’it occupies an intermediate position between the two ,both “lachesis and opium”can combat cerebral paralysis.
When the dropping of the lower jaw is the prelude of impending danger when syncope is of cardiac –asthenic origin “lachesis” should be compared with “arsenic” “hydro-cynanic acid” “digitalis” veratrum and camphora”
In those incomplete reactions which leave behind an accentuated musclar asthenia “gelsemium is the first remedy verified ,particularly after grip and other infectious fevers .This drug affects especially the motor nerves ,cauging prolonged exhaustion of the forces with a marked disinclination to all bodily and mental effort ,the muscles refuse to do their work and feel notably sore ;and this is a condition which frequently indicates “ gelsemium”in certain early cases of typhoid fever ,exhibiting mental ,corporal and vascular excitability ,with languor insomnia vertigo drowsiness and an agitation less marked than that of “aconite”there are other cases of incomplete and doubtfull reaction ,usually noticed after acute supporative diseases or prlonged and debitating losses of blood and other vital fluids (hemorrhages ,sweats ,diarrhea, etc..) for which “china” is very important remedy especially when these losses cause an extreme ,china is also our leading remedy.when the patient after repeated attcks of acute malaria falls into a state of cachexia which is due to the anemia and in a great measure to the persistency of certain alterations of hepatic or intestinal mucosa remains so impressible that the least excess in the regimen ,bring a return of the diarrhea and even of the complete attacks ,with its usual consequence and creating besides painfull digestive troubles of long duration if as it happens occasionally ,the reaction is excessive that is accompanied by an intence febrile excitement with congestion face and conjunctiva,tumultuous beating of the heart ,full of frequent pulse , violent headache an essential remedy is also phoshorus particularly in typhoid or asytolic states during the course of pneumonia and broncho-pneumonia with dilatation or fatty degeneration of the heart or in adynamic conditions of phthsis with repeated hemoptysis stertorous .breathing frequent fainting spells ,cold sweats and threatening paralysis of the lungs .phosphorus is to tuberculosis what sulphus is to scrofulosis according to thinks ,the same relationwhich exists between “phosphorus and phosphoric acid “-“arsenicum and rhus tox” ,phosphorus takes the first place in the most intense forms of of functional torpor ,particularly in the atxo—adynamic form of depression,with impending paralysis of either the brain or lungs .
This is the position which warm and kaspar give to carboveg which I consider inadmissible for phosphorus is an erethistic remedy with a rapid transitionto torpor ,but always exhibiting an asthenic irritability ,inferior only to that of arsenicum.
The physical or nervous prostation indicative of this drug is produced by a prolonged or exposure to active morbific infuences ,syncope is frequent and sudden with more or less reaction or the patient falls into a comatose state ,as if life wore extinguished .
We should not forget the curative power this remedy in apoplexyand its immediate consequences , particularly in old age, like “antimonium tart” is often indicated in pneumotyphus and pulmonary edema ,with much rattling of mucus , intense dyspnea and great prostration of the forces. .case in which “moshus”come often to complete the cure .
For the typhoid state which sometimes supervenes during acute atrophy of the liver ,few remedies can take the place of “phosphorus”. In case of cholera asiatica which commence with collapse supervenes 12 or 24 hours after the attack ,we find “arsenicum and veratrum” more frequently indicated, ”camphor” corresponds almost exlusively to that variety of cholera called cholera sicca in which diarrhea and vomiting are either moderate or entirely wanting ,thirst if it exists is insignificant but as in “arsenicum”,anxiety and agitation govern the scene .it is in this class of cases where “camphora” administered in the mother tincture ,a couple of drops every 15 minutes has brought the most admirable reactions. We should bear in mind ,how ever that when not indicated or given in too strong and repeated doses it roduces a burning ,epigastric distress which puts the patient in despair and which according to Carol Dunham a few doses of “phosphorus” will relieve .“psorinum” is indicated when there reactionary inertia ,after severe diseases especially when convelscence is protracted ,with out known cause and the patient is weak and nervous and despairs of recovery or when in a sickly constition ,we suspect the existence of a latent toxic influence ,such as tubercle scrofula or psora. It may become a valuable remedy when the dystrophic conditionhas been preceded by the retrocession of a rash like “sulphur”it serves to stimulate the dormant energies of the system and the enervated cells bringing about the needed reaction ,when other remedies have failed to produce permanent improvement .In certain typhoid states ,with sensorial depression Hahnemann prescribed successfully “nitri spiritus dulcis”a few drops of the pure substance in half a glass of water every two or three hours until reaction took place it corresponds to those cases too mild for “phosphoric acid “ with out nervous and cascular erethism,in which also the patient can be momentarily aroused to fall back again into deep stupor ,spiritus nitrosi seems to correct the destructive metabolism probale cause of the reactionary inertia ,as evinced by the increased renal elimination and the diminution of urea and the solids.
“cocculis indcus” has also been recommended for those cases of incomplete reaction ,in troubles of spinal origin exacerbated by prolonged night watching or insomnia and persistent anemia .In typhoid states of exlusively nervous type in which the cerebro –spinal nervous system can not get rid of the toxemic effect cocculus will aid readily the reactive forces of the system warn recommends it in those cases where the animal life or of relation is deeply affected while the nutritive functions are hardly implicated.
“Arnica “ is one of our powerful agents when syncope or collapse is the result of serious mechanical lesions or attended by cerebral congestion with cold pale face ,vertigo and loss of consciousness, it is always indicated in traumatic fevers with great depression of the vital forces and which are due to an accidental contusion or shock complicated or not with fracture or lacerations a remedy of some importance in syncope in” secale cornutum”especially when it occurs as the result of persistent hemorrhages ,during labor with algidity and loss of conciousness in debilated ,cachectic women.also in the collapse of cholera asiatica with convulsive movements of the muscles glacial coldness and almost complete extinction of the pulse and voice “valeriana and ambra grisea”have been favourably mentioned for incomplete reaction during the course of nervous affections when the organism seems not to respond to the actions of any indicated remedy but I think “moschus”should be preferred when the enervation is extreme and the malady does not follow its usual course ,either remaining stationary or developing serious abnormal phenomena , this remedy is also useful during or after serious fever presenting repeated attcks of syncope with gradual lowering of the pulse audible mucous rattling and nervous inquietude indicating impending paralysis of the lungs .the lack of reaction when it occurs in hysterical women during serious illness ,however ciaims the employment of “castoreum” a neglected remedy worth of our study in these cases , particularly if due to spasmodic disorders and extreme exhaustion convalscence is protrcted and distressing ,asthenic irritability and predominance of abdominal symptoms are charecterstics of this drug.
“Capsicum” is of useful application and has given good results in those cases of functional torpor occurring in obese individuals of lax fibre gouty or hemorrhoidal with enlarged and tender liver and spleen ,particularly so in those who suffer from malarial cachexia with perodical spells of fainting and great inclination to lie down and sleep.
In a case of brusque asystolia with precordial anxiety distressing nausea and deathly paleness of the face ,I obtained a rapid and excellent result from “tabacum”which is also indicated in collapse when the tremor and pallor are extreme and nausea and vomiting return on the least motion of the body.
In the collapse of old vigorous gouty subjects ,”colchicum” should not be overlooked ,especially in typhoid states with great oppression and dyspnea.
‘Lycopodium” able to operate true and permanent reactions particularly so in typhoid states with pulmonary localization .Ido sincerely believe that many cases of reactionary inertia treated with “lycopodium” by virtue of its profound action on destructive metabolism and its undeniable power to urge the enervated cells to act and bring about reaction.
Dr.(mrs) B.S.SUVARNA ,B.A, D.I.HOM ( LOND ), M.I.H, Ph.D.(ITALY)
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