Bachmann. Taylor only speaks of the general action of arsenic on the skin, without specifying the genital region, though he refers to the observations of Watson. Stahl and Hahnemann, says Orfila, mention as the effects of arsenious acid, inflammation and swelling of the genitals, going even to gangrene, with extreme pain; sudden gangrene of the male genital organs. We may conclude by saying with Wurmb, one of the most distinguished homœopathic physicians, that arsenic has a particular affinity for the sexual organs of both sexes, and it is to be regretted that its properties have been so little studied in reference to them.* It is on this account that I have wished to direct attention to this point of arsenical pharmacodynamics, by compiling all the facts I could meet with throughout our scientific literature. I have incidentally treated of the same subject in another work.† In his personal experiments with arsenic, Hahnemann does not mention its action on the genitals. Were we to describe minutely all the numerous effects that have been observed in those parts caused by this celebrated poison, we should be adding still more to the "innumerable symptoms" which, according to Drs. Trousseau and Pidoux, the homœopaths have discovered in arsenic, and which these two respectable physicians characterise as the "reveries of hypochondriacs." I have already shown more than once with what scientific frivolity, and with what ignorance of the facts, the authors of the Traité de thérapeutique et de matière médicale have treated the question of homœopathy in the matter of arsenic. When we are in possession of the facts we find we must add to the pathogenesis of arsenic. These "innumerable symptoms are still more numerous than Hahnemann makes them, and than Drs. Trousseau and Pidoux think; what then دو * Wurmb, Der Arsenik, &c. (Oesterr. Zeitsch. f. Homöopathie, Wien, 1845). + Histoire des éruptions arsenicales (Moniteur des Hôpitaux, 1857). Reine Arzneimittellehre, 1st edit. [In the 2nd edit. of the R.A.M.L., and in the last volume of the Chron. Krank., Hahnemann gives several effects of arsenic on the genitals observed on himself, and he mentions also the observations of Pfann, Degner, Stahl, and an anonymous author.] is to be done? With respect to the opinions of M. Trousseau respecting homoeopathy, so often expressed, either in conjunction with M. Pidoux or in his other works, it would be easy for me to prove that his trenchant expressions are nothing but a tissue of errors, paralogisms and contradictions. The illustrious professor in this matter strangely abuses his scientific position, and I hope to prove this to him sooner or later, with God's help: ab uno disce omnes. Such are the physiological facts respecting the action of arsenic on the external genitals. From them we may deduce important therapeutic principles from the twofold point of view of the law of similars and the law of elective affinity. Unfortunately the facts are not sufficiently numerous to enable us to apply them as a criterion for forming a useful theory.* Clinical experience must be interrogated as to what arsenic can do in the numerous disorders of the external genital parts. The law of similars and the law of elective affinity are two sure guides to lead us to the specialisation of the action of medicines; and in order to solve this unknown problem, we only need to avail ourselves of the formula similiter et elective, while bearing in mind the final criterion, ab usu in morbis. In connection with this subject we may give an abstract from an article in a French journal, furnished by the Wiener medic. Wochenschr. (1864, 39 and 40), and reproduced by the Allg. Hom. Ztg. (November, 1864). The title of the article is On the Action of Arsenic on the Sexual System. The Gazette des Hôpitaux of the 23rd July, 1864, gives, in an interesting leading article, a complete survey of the anaphrodisiac effects of a long continued use of arsenic, whence we extract the following: Very different from former times, in which the therapeutic employment of arsenic had to contend with many * Comp. Mémoire sur le prurit vulvaire, par Imbert-Gourbeyre (Moniteur des Hôpitaux, 1858). unfounded prejudices against this truly heroic remedy, nowa-days too much assurance, and an optimism not without danger, prevails with respect to its general use. Though it is quite true that as a rule the administration of arsenic in a methodical manner may be long kept up without any inconvenience to the patient, still it is not less true, that in some cases where the treatment has just been begun or has lasted for but a few days, effects more or less disagreeable ensue from its use. Among these effects which have of late been particularly studied, is one in particular, the existence of which is unknown to many, I refer to arsenical anaphrodisia. Thus we find that in many of the most recent pharmacological manuals, such, for instance, as the latest editions of Trousseau and Pidoux, of Pereira, and of Oesterlen, this effect of arsenic is not alluded to. Rayer alone, in his article, "Arsenic," in the Dictionnaire de médecine et de chirurgie pratique (vol. iii, p. 372), says that arsenic sometimes causes "a true paralysis of the genitals." As a proof he cites a case observed by him in La Charité of a printer, twenty-three years old, who was affected with lepra, and was treated with Fowler's solution. The effect of this medicine was to produce a true paralysis of the genital organs that lasted eighteen months. Charcot adds two more recent observations to this older one. The subject of the first was a man, æt. 42, who had been affected with psoriasis of the whole body since his fifteenth year. When twenty-seven he commenced to use arsenical preparations, which he took every year for two or three months continuously, and in progressively increasing doses; sometimes he repeated this arsenical treatment two or three times a year. After each course his disease was ameliorated; the patches disappeared. But they recurred just as certainly after a few weeks or months. The patient therefore was compelled to have always recourse to arsenic, and he was so insensible to its action, that he could take five centigrammes of arsenious acid daily for several weeks at a time without experiencing any particularly disagreeable effects. The only symptoms he felt were a little ptyalism, and some slight gastro-intestinal derangements. In 1857 the skin became of a permanent dirty-brown colour, especially in those parts usually exposed to light. In 1852 this man came to Charcot complaining of a symptom he had had for three months that plunged him into the deepest melancholy. His sexual functions, which had formerly been very vigorous, were seriously threatened; the erections had become rare and incomplete; coitus was almost impossible. Charcot advised him to leave off the arsenic completely for a long time, and after he had done so for four or five months, the former vigour of his sexual functions returned. The second case related by Charcot is that of a man, æt. 35, who, on account of psoriasis, took for many years pills made of Ars. lixiv., and afterwards Fowler's solution, and thereby was rendered impotent. On leaving off the arsenic the anaphrodisia disappeared, but the skin disease returned with increased virulence. A fresh employment of arsenic was again followed by anaphrodisia. In both these cases it was ascertained with certainty that the temporary impotence was only attributable to the use of the arsenic, as it went off when the medicine was discontinued. In the second of these cases the impotence again occurred, though a smaller dose of the arsenic was taken-twenty drops of Fowler's solution daily, which shows that the anaphrodisia arsenicalis is not always to be ascribed to an abuse of arsenic. From the three cases alluded to, it is evident that anaphrodisia belongs to the possible consequences of taking arsenic, though it is one of the slowest in being developed. That this effect can be cured by the mere discontinuance of the drugs we learn from the cases cited, in all of which also the symptoms recurred after the resumption of the use of the arsenie. REVIEWS. New Remedies, their Pathogenetic Effects and Therapeutical Application in Homœopathic Practice. By EDwin Hale, M.D. E. Lodge, Detroit, Michigan; Turner, 77, Fleet Street, London. 1864. THOUGH not in the direct ratio, yet in a certain proportion, our powers of combating disease depend on the number of specifics at our command, therefore Dr. Hale has rendered excellent service by the publication of the above work, and deserves the best thanks of our body and of medical men in general. We have here no less than forty-four medicines rendered accessible to the practitioner by being either made known to him for the first time, or collected together from the various periodicals where the provings were first published. If not already in the hands of all our readers, we recommend them to procure the book without delay. There are some medicines, already partially known to us, given in a more complete form, both as to provings and clinical use by homœopaths and allopaths, of various kinds, though still all more or less incomplete, yet our knowledge of them is brought up to the day, and in such a way as to make us grasp with considerable accuracy their sphere of action. These are: Æsculus Hippocastanum, Apocynum Androsemifolium and Cannabinum, Arum, Baptisia, Caulophyllin, Cimicifuga or Actæa Racemosa, Collinsonia, Eupatorium, Gelseminum, Hamamelis, Hydrastis, Phytolacca, Podophyllum, Sanguinaria and Veratrum Viride. In addition to these we have others almost quite unknown to us, and though not so completely proved as the above even, yet still enough to make a beginning and introduce us to their use. Some of them seem very promising, and will fill up some much felt gaps in our Materia Medica, if they turn out as well as they promise. These are: Asclepias, Chimaphila, Cornus, Dioscorea, Erigeron, Helonias, Iris, Leptandria, Senecia, Trillium, &c. |