616. Therapeutic Uses

In Typhus and Typhoid Fevers; and in pevers, whatever may have been their original character, when they assume this type, Camphor proves a remedy of great value and power. Dr. Copland,* after quoting a large number of German writers in its favour, observes that he has prescribed Camphor, not only in the above fevers, but also in pestilential, exanthematic, puerperal, and common continued fevers, and that he is satisfied as to its good effects, either when exhibited as above, or when combined with other appropriate medicines, and when given in proper doses. In the stage of excitement attended by vital prostration, the dose, and the medicines which should be associated with it, should have reference to the state of vital power, to the mildness or severity of the disease, and to the nature of the prominent affection or complication. As the disease passes into the nervous stage, and more especially as this stage passes into extreme exhaustion, the dose of Camphor should be increased, and conjoined with stimulants, tonics, and antiseptics. The inflammatory state of any organ supervening in the course of typhoid fevers does not contra-indicate the use of Camphor, if given appropriately to the degree of vascular action and of vital power. Hufe-land directs a solution of Camphor in Acetic Acid to be taken internally, and used externally, early in most states of typhoid fever. Prof. Huss,t who speaks highly of the efficacy of Camphor in these diseases, considers its contra-indications to be - 1, a flesh red tongue; 2, tenderness of the abdomen; 3, diarrhoea.

617. In Asthenic Inflammations, and also in the advanced stages of Acute Inflammation when the vital powers are greatly exhausted, Camphor in large doses, conjoined with other stimulants and sedatives, proves in the highest degree beneficial.

618. In Inflammation of the Brain, after the due employment of depletion and evacuants, when great watchfulness is present, or great irritability or mental excitement exists, narcotics may, in some instances, be given with advantage. Great caution is necessary in their selection and employment; but as Dr. Copland observes, where the propriety of having recourse to these medicines admits of a doubt, they should be combined with moderate doses of Camphor. When the disease arises in the course of typhoid fevers, Camphor, as advised in sect. 646, is one of the best medicines we possess. In such cases it may be advantageously combined with Calomel. In delirium accompanied by depression of the nervous energy, and of the vital powers, Camphor proves eminently serviceable, and should be conjoined with tonics, sedatives, &c. If the delirium be accompanied by coma or stupor, it may be given in large doses, combined with the more powerful stimulants. Its use in these cases requires caution.

* Dict. Pract. Med., vol. i. p. 1030.

Dublin Journ. of Med. Science, Sept. 1845.

649. In Small-pox and the Exanthemata, Camphor, given internally, is stated to be effectual in restoring the eruption, when, from any cause, it has receded. In confluent or malignant Smallpox, when the vital power is greatly depressed, Camphor alone, or combined with Opium, may be advantageously employed It is inadmissible when inflammation of important viscera supervenes. Rosenstein states that, if a portion of the skin be smeared with Camphorated ointment, no pustules will appear on that portion; but Pereira regards the statement as incorrect.

650. In Insanity, Camphor has been advised by Percival, Hufeland, Millingen, &c, but is unfavourably spoken of by Prichard, Haslam, and Burrows. Dr. Copland entertains a high idea of its value. When the disease occurs in persons of a nervous temperament, or whenever it is connected with deficient nervous or vital power, - when the head is cool, and the mental affection is independent of vascular fulness or action, - when depletion and alvine evacuations have been carried sufficiently far, - or when exhaustion follows these or previous excitement, he considers that Camphor may be given with advantage. Dr. Millingen observes that it is not advisable when there is cerebral excitement, with a hot skin, full pulse, and wild countenance; but where there are much restlessness and uneasiness, with a low weak pulse, or cold and clammy skin, it will be found most beneficial. Its use, he adds, requires much discrimination. Dr. Copland prescribes it in combination with Morphia, Hyoscyamus, Belladonna, or with Nitre or Digitalis; but the dose, as well as the combination and mode of exhibiting it, ought to be regulated by the peculiarities of the case, and the effects of previous treatment. He speaks favourably of the mode of administration advised by Esquirol: - dissolving from 3ss. to 3j. of Camphor in fij. of Vinegar, and giving it in an aromatic infusion, in the course of the twenty-four hours. Cold applications to the head, the shower-bath or tepid bath, may be resorted to during its use, especially when increased heat of the skin or scalp is caused by it.

651. In Puerperal Insanity, Camphor, given as advised by Esquirol in the last section, has been found highly serviceable. Dr. Copland prescribes it (gr. v.) with an equal quantity of Hyoscyamus in the morning and afternoon, and double this quantity of each at bedtime. Dr. Prichard§ speaks favourably of it, given in combination with the Sesquicarbonate of Ammonia.

* Dict. Pract. Med., vol ii. p. 253. Aphorisms on the Treatment, &c. of the Insane, Lond. 1840. Loc. cit.

Op. cit. vol. ii p. 548.

§ lib. of Medicine, vol ii. p. 142.

In Delirium Tremens, occurring in persons of a nervous habit, where the exhaustion is great and Morphia inadmissible, Dr. Laycock* states that Camphor (gr. ij. - iij. every third hour) sometimes proves useful, or it may be given combined with AmmoniAe Carb. and Henbane.