Camphora bromata

Volume I — Main text

Camphora bromata. Monobromide of camphor, a compound in which one atom of hydrogen of the camphor has been replaced by bromine (CWHOi«Br.)

I. Provings. — i. I administered 10 gr. in pills to a healthy adult at 2.30 p.m. after a meal, pulse before taking it being 96, temp. 993^, resp. 19. In I h. pulse had fallen to 70, at end of 2nd h. it stood at 74, and in another h. had returned to its normal rate (which with him was a high one). During the 3 h. resp. became less by i per m., and temp. feU i^. On succeeding e., some time after a meal, 16 gr. in same form were taken, pulse being 96, resp. 18, temp. 99°. After I h. pulse was unchanged, resp. 16, temp, had fallen half a degree ; after 2 h. pulse 86, temp. 99°, resp. 19. In another h. all was normal. Throughout whole time there was no hypnotic tendency, nor was there pain in any part of body. Head remained clear, and condition was one of general comfort. Later, one afternoon, shortly after a meal, I gave 5 pills of 4 gr. each \ pulse 96, resp. 20, temp. 992°. In I h. pulse 80, in 2 h. 78, in 3 h. 96 again. Resp. and temp, were reduced in same ratio as before. (On experimenting with camphor alone, results were found to be very similar.) (Lawsow, Pract,^ xiii,

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II. Poisonings. — I. The Archives of the late Dr. George M. Beard

are responsible for the details of a case which is to say the least curious, and which should be further tested and studied in the light of extended experiment.

a. In a young man, apparently in fair health, and not troubled in the least with indigestion, in the ordinary sense of the term, the contact of a cold and clammy hand with his own, or the sight of a person afflicted with physical deformity, was sufficient instantaneously to produce the most violent paroxysm of gastric catarrh, accompanied by such severe and exhausting throes of convulsive action, that the danger of death from su£Focation was by no means an insignificant element. On several occasions the patient actually fainted from exhaustion before relief could be obtained ; and the whole gamut of ordinary tonics and sedatives having been tried in vain, a medical expert was finally consulted, with a view to allay an irritability as inconvenient to a man who wished

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to enter upon a medical career, as it was peculiar and inexplicable* Among the curious features of the case was the fact that the patient could endure the actual presence of odours of the most offensive kind j and yet so strong was mental association that the mention of such an odour often resulted in a violent attack. He could bear the effluvia and sights of the dissecting-room for hours together without inconvenience, while the glimpse of an insane or idiotic face would induce an instantaneous paroxysm of such intensity and violence that medical assistance had to be summoned.

Monobromide of camphor was administered in 3-gn doses every 3 or 4 h. with excellent effect upon the gastric irritability, but was followed by most curious mental phenomena.

The patient thus states his own case :

h, *' I took the monobromide of camphor as prescribed for a weeic or more with decided alleviation of the gastric trouble, and had begun to congratulate myself that I could endure the presence of a cuspidor without disagreeable symptoms or disturbance of my internal peace, when a novel and very peculiar train of effects supervened, and the drug began to have a tangible and decided influence. From 30 m. to an h. after takmg the dose a strange doziness stole over me, I did not drop to sleep in the proper and natural acceptation of the word, but rather fell into a species of trance of 5 or 10 m. duration, my eyes remaining open and my senses as acute as ever — perhaps a trifle more so. The next step was an unexpected and curious one.

c. ** One afternoon, about 3 o'clock, I took the Sixth Avenue elevated train, intending to alight at Twenty-third Street. I entered the car at Park Place, and had been seated 2 or 3 m. when one of my monobromide trances supervened. The buzz of conversation about me was perfectly audible, and 1 was conscious of all that was passing, I came to myself with a start at Bleecker Street station. My first impression was that I had boarded the wrong train ; I was completely ' turned round,' and could not disabuse myself of the idea that the train was going south instead of| north. I studied the landmarks and the numbers of the streets one after another from the car window, and soon satisfied my mind that I was travelling in the right direction. But the ftdsc sensory impression stili continued. I had not altered my position during my doze, nor had the direction in which the train was moving been shifted in such a manner as to account for the strange delusion of the senses. 1 got out of the car at Twenty-third Street, as I was in the habit of doing, and started to walk home — I had apartments in Twenty-eighth Street^ — but, familiar as every landmark was, the false sensation was not corrected by my descent to the street, I walked up Sixth Avenue under the impression that I was walking down, and turned to the east when I arrived at the corner of Twenty-eighth Street, under the impression that I was turning to the west. The false sensation — there is no other accurate name for it — persisted until I entered my room, when, with a sudden transition, it disappeared, and I was correct again as to the points of the compass. From the date of this experience the phenomenon was one frequently repeated, and at first I was rather amused and studied its features with something akin

to curiosity. On the Third Avenue elevated railroad, and on the Third, Fourth, and Sixth Avenue surface cars the condition was equally sure to supervene, provided that I had taken my dose of monobromide a few m. previous to setting out, and so common did it become in the course of 4 or 5 d. that I acquired the partial habit of moving about by reference to landmarks, instead of doing so in the semi-automatic way usual with people who are ^familiar with the ground that they are traversing. One fact I soon ascertained beyond a question, and that was that the phenomenon was not due to any external cause, alteration in my position, or in the direction of the car while I was dozing, but to some internal and unique ph3rsiological effect of the medicine. In every instance the points of the compass were exactly reversed. North seemed to be south, and east seemed to be west, and there was no variation from this rule, no partial reversal of the cardinal points^ during the 4 or 5 weeks that I was taking the medicine.

d. ^I haa been the victim of more than 20 such experiences — trances I may style them, for want of a more accurate term — followed by a complete reversal of the points of the compass, which generally lasted for 10 or 15 m., and then suddenly cleared away. But as the monobromide was answering admirably the purpose for which it was prescribed, I still continued to take it. One afternoon as I was riding up Third Avenue, I fell into a doze as the car was passing Cooper Institute and did not recover my normal condition until the conductor called Twenty-fourth Street. As usual I was turned round, and I walked home in that uncomfortable but now familiar state. To my astonishment— an astonishment that deepened into terror as the hours went by — the £tdse impression was not dispelled, as it had always been previously, on entering my room, but remained through the evening, and was still present, like a strange nightmare, when I went to sleep. I passed a few h. in troubled slumber, vexed with ghastly dreams.

e. ^ My first impulse on getting out of bed in the m. was to step to the window and ascertain whether I was still ^ turned round.' The sun was just struggling into view above the cornices of the buildings, and, to my terror, it seemed to be rising in the west. The impression persisted during the whole d., although I at once discontinued the monobromide, and I retired to bed that n. wearied, bewildered, mentally tired with the constant vigilance I had been obliged to exert in order to prevent mistakes in walking about the city in pursuit of my usual vocation. Innumerable large black flies seemed to be flitting and coursing in swarms to and fro across the field of vision ; lances of pain shot from temple to temple, and, at the base of the brain, a dull benumbing sense of pressure extended upward in the direction of the coronal region. I fell into an uneasy drowse about midnight, and slumbered for several h. without obtaining any real rest or repose. For a 2nd, a 3rd, and a 4th d. the sensation persisted. To describe what I suffered would be to tax language beyond its resources, the condition was one so whimsical in its nature, and yet so maddening in its e£Fect on brain and nerve — so torturing in its eternal conflict between the senses and the understanding. No one who has not experienced the result of a protracted strain of the faculty of attention such as I was

obliged to endure, can possibly comprehend how such a condition taxes one-s physical forces. At the end of the 4th d. I was prostrate in mind and body, and so enfeebled that I could scarcely walk. I saw no relief from the tension but death, thanked God fervently when I began to be a little dozy, and went to sleep earnestly hoping that I might wake up with my points of the compass properly adjusted or never wake at all. Fortunately my petition was granted ; another d. of such torture muse have ended in insanity or brain fever. The next m. the sun rose in the east as usual, and I went about like one who had been released from a troubled dream i but it was many d. before my nerves fully recovered from the shock they had sustained| and even now I shiver at the recollection of my suflFering."

yi Dr. Beard's explanation of the case was : ** That by some abnormal action of the drug, some interference, most likely, with the cerebral circulation, the initiative was transferred from the L hemisphere of the brain to the r. It is a familiar fact that, under normal conditions^ all our muscular impulses originate in the 1. hemisphere of the brain and are transferred to the r. The 1. lobe of the brain leads, the r. follows, and thus the activities of a mass that actually consists of two brains which are functionally independent of each other, arc co-ordinated and work together in harmony. If both hemispheres acted simultaneously and independently the result would be double thought, double life, disorder, and contradiction. Each hemisphere being, then, so far as nervous functions are concerned, both motor and sensory, a per* feet brain, one must be subordinated to the other in function, or confusion would result ; and it ts probable in point of fact that many strange psychological phenomena actually arise from temporarily interrupted or defective co-ordination ; as when, for example, a man has the momentary consciousness of double being or of living a double life — a phenomenon due, no doubt, to the momentarily independent action of the two masses. In the case of the young man, it is probable that the coordination of the two hemispheres was disturbed, and that the r. for the time being assumed the initiative that had so long appertained to its fellow.

g, " The result was a complete reversal of the established associations of the sensory and intellectual life. As the effect of the sedative wore off and the normal circulation was re-established, the 1, hemisphere resumed its former hegemony, and the natural order of things was restored.

A, ^'It is possible, again, that the trouble was confined to the optic nerve and its lobes, and did not extend to the whole cerebral mass* A little anatomical study will readily explain how this might occur, with the exact result described by the patient. But this is certain, in any event, that the old explanation of being ' turned round ' did not hold good in the case under consideration, and that a deeper and more occult cause must be assigned for it.** (A^. K Mid, Ttmts^ April, 1883*)

III. Experiments on animals. — r. Like other bromides, it produces weakness and paralysis, stupor and sleep* It slows pulse and respiration, and reduces temperature* In the rabbit the vessels of the eye and ear are contracted. When given for a length of rime it produces

marked emacfation. In large doses it has caused epileptiform convulsions. (Brunton, Pharmac$l§iy^ p. 930. Summary of De Bournevine's experiments in Practititmr^ xiii, 112.)