Carboneum Sulphuratum — Homeopathic Remedy Profile

Carbon bisulphide entered the materia medica through the workers who breathed its fumes in nineteenth-century vulcanizing sheds. Its picture combines the two elements it is compounded of and adds something neither parent gives on its own: a slow, disorganizing penetration of the nerves and the special senses. Its action is deep and disorganizing, and the range of symptoms it covers is immense. It is prescribed across the usual range, from low attenuations to high potencies.

At a Glance

Source and Preparation

The substance is carbon bisulphide, also known as alcohol sulphuris or alcohol lampadii, a solvent much used in the vulcanisation of rubber. The homeopathic preparation is by solution in rectified spirit. H. H. Crippen collected in the Medical Argus the cases of workers intoxicated by the fumes; this industrial pathology is what established the proving and is cited by Boericke and Clarke.

One of Crippen's records concerns a girl of fifteen employed in a vulcanising works. Exposed to the fumes for a whole day, she developed pain in the forehead and a heavy head. Painful contraction of the masseters followed, then stiffness of the neck and vertebral column, and finally of the legs and arms. Her jaws locked and could not be parted, and an ulcerative stomatitis developed, with tartar depositing on the teeth. A slighter but distinct exposure had preceded the collapse. The whole range of symptoms is what the remedy holds in dynamic form.

On record is E. Case's cure with Carboneum Sulphuratum 30C in a slender, nervous woman. She felt as though a weight pressed between her shoulder blades and forced her to stoop; her dorsal spine throbbed as though a heart beat inside it; she was constipated and urged to no effect; and bright blood came from the rectum after stool.

The Essence of Carboneum Sulphuratum

The remedy meets broken-down, weak constitutions. Lack of vital heat is a keynote, and yet the same patient is worse from warmth. Warm rooms aggravate. Warm applications aggravate. The seeming contradiction resolves when one sees that the whole thermal regulation has been disturbed. The mucous membranes are anesthetic. The skin is anesthetic. The muscles waste. The senses dim. A feeling of vibration and trembling runs through the whole body, and particularly through the hands.

Pains come and go quickly. That signature is the constant across every region. Flying sharp pains in the chest, in the stomach, in the limbs; each appears, passes over, and returns. With the pains there is periodicity. It is fixed at six weeks: the diarrhea returns on that interval, and other complaints follow suit.

Where Carbo-veg gives flatulence, and Sulphur gives abdominal soreness, Carboneum Sulphuratum gives both. Where those two are worse from warmth, this remedy inherits the same reaction and carries it into a wider disorganisation of the nerves and senses. Broken-down cases with a history of alcohol, of coal gas, of chronic lead poisoning are its ground. Impotence is one of the italicised keynotes.

Clinical Portrait

Mind and temperament

Memory fails, especially for words. Sluggishness of mind. Confusion during headache. Dullness in children, with childish behavior, sometimes idiocy. Great excitement at night, so much so that the patient has to be confined. Irritability, anxiety on waking in the morning, anxiety in bed, anxiety at night. The mood changes without cause, tipping between extravagant gaiety and destructive anger. Dementia alternates with excitement.

He is oversensitive to noise, and fear comes on when he walks in the dark. The delusions circle around persecution and injury. The patient believes himself surrounded by enemies. He feels sure he is on the point of being injured. He talks of money in his delirium. He hears voices. One of Crippen's patients was convinced he had committed a robbery. Another sensed a hole right beside him that he was at risk of tumbling into.

Hallucinations of sight and hearing collect around visions of magnificent grandeur, delirium with incoherent talking, singing. The patient searches for things lying in front of him. He is violent and vehement, wants to strike, wants to bite. His disposition is suicidal, to the point of throwing himself from a window. A gentler and curious sign belongs to the same picture: cheerful and free from care after wind is passed.

Head

The head aches as though a tight cap were on it. A dull, muddled feeling in the forehead. Constriction of forehead and occiput. Pressure that increases until it causes confusion of mind. Brushing the hair is painful. Single nodules on the head, sore to touch. Noises in the head accompany the pain. The head sinks forward while walking. Sweating relieves the headache; coldness accompanies it; feverish attacks appear with it.

After stool, the headache is joined by stitches in the ears and pressure in the stomach. This radiating, cross-regional pattern is characteristic of a remedy whose action does not stay within any one organ.

Eyes and vision

Boericke and Clarke both name the eyes as the special affinity, and each preserves the same picture read backwards from the amblyopias of tobacco workers and coal-gas victims. Sight fades. Objects fade away. Everything looks foggy, as though veiled by a spider's web. Central scotoma appears for light and colors. Myopia. Asthenopia. Achromatopsia. Dyschromatopsia. Color-blindness for red and green, but not for white.

Cloudiness of the optic disc, then atrophy. Optic neuritis advancing toward atrophy. The retina is congested; its vessels are tortuous, the veins distended and the arteries contracted. Reading brings on lachrymation. The lids are heavy, sore on moving, quivering. The eyes look sunken and expressionless, with gray rings beneath. Vision is better in the evening, in twilight, and after eating.

The extreme term of the same line, preserved in Crippen's report, is a patient who suddenly lost consciousness and was left with complete right-sided hemiplegia, blind in the right eye and with the sight of the left greatly impaired.

Ears

The ears ring and hearing is poor. Noises in the head. Deafness, as though something fixed were blocking the ears. Buzzing and singing like an Aeolian harp. Sharp pain in the ears after stool. Pain in the left ear when swallowing, and sharp pain in the right. The remedy takes its place in the differential of tinnitus and of Meniere's disease.

Mouth and teeth

The italicised keynote: warm food in the mouth sets off toothache. Where cold in the mouth relieves and warmth in the mouth provokes, the differential lies between Carbo-veg, Sulphur and this remedy, and Carboneum Sulphuratum stands where the wider picture of anesthesia, tremor and broken-down constitution is present. See also the toothache page.

Anesthesia of mouth and tongue. Neuralgia of the teeth. Taste sweetish, foul, bitter, sour, pappy, metallic. Tongue cold, or burning and stiff. The speech turns into a childlike lisp and stammer. The lips ulcerate; they look blue and moist and jerk convulsively. The fifteen-year-old vulcanizer's ulcerative stomatitis with its deposit of tartar is the industrial background of the mouth picture.

Throat and voice

Burning in the throat extending to the stomach. Tickling in the back of the palate after lying down that provokes a violent, dry cough. It feels as if a hair had lodged in the throat, or as if a piece of bone had lodged in the esophagus. A sharp, contracting pain. A scraping feeling, pierced by fine stitches. Goitre. The voice is weak and pitched low; there is hoarseness, an irritation that makes the patient hawk, and heat in the larynx. Clergyman's sore throat with the failure of vocal endurance familiar to preachers and teachers.

Chest and breathing

Sharp pains under the short ribs. In the chest, burning and sharp pains fly about, pass over quickly and often return. Oppression and fullness. Constriction, as if breathing out were impeded; deep breathing and open air relieve it, and climbing steps makes it worse. The chest feels warm and full, and breathing is difficult. Expiration hot. Emphysema. Asphyxia, whether from coal gas or from alcohol.

Sneezing with sensitiveness in the chest. Cough from irritability of the larynx. Lying down brings on cough. A tickling in the posterior palate excites a cough that strains the chest and leaves it sore. Cough from heartburn.

Stomach and abdomen

Heartburn worse from pressure. Sour eructations after coughing, and sour eructations with much sour flatus that is better from belching. Distension better from noisy eructations. Burning pains. Flying sharp pains in the region of the stomach. Stomach as if tied together. Loud belching. Nausea with fainting spells, relieved once the patient belches or vomits. Food is vomited with glairy mucus, or bitter water comes up. Going into a room, or out into the open air, brings an inclination to vomit.

The appetite is ravenous, then disappears. The patient is hungry yet averse to eating, very thirsty, craves beer and dislikes meat. Tobacco, wine, beer and alcohol all make things worse. Whiskey makes him drunk to the point of unconsciousness. The remedy's affinity for cases broken down by alcohol finds its stomach here.

The abdomen is distended, sore and rumbling, and the flatulence eases after stool. Twisting, rolling and rumbling as if diarrhoea would set in. Cutting pain in the bowels. Abdominal walls as if bruised. Pain with swellings that wander about as if caused by flatus, a sensation of a moving lump beneath the wall. The navel is painfully drawn in. Strangulated hernia. Griping about the navel, together with an urge for stool. Liver disorders go together with edema of the feet.

Rectum and stool

Itching and burning at the anus. Constipation, accompanied by belching or by herpes. Diarrhoea; and fetid diarrhoea alternating with constipation. Offensive, frequent passage of flatus that relieves — the "cheerful and free from care after wind is passed" translated into a bodily register. Periodic diarrhoea returning every six weeks.

Burning pain, weakness and trembling in the rectum. Stool not increased in quantity, but accompanied by tenesmus. Yellow, frothy, sour-smelling fluid at night. Stool with retraction of the umbilicus. Stool thin, papescent and small. Bright blood from the rectum after stool, as in E. Case's cured patient. After stool, headache with stitches in the ears and pressure in the stomach.

Urinary organs

Cramping in the bladder and its neck. Urging to urinate with only a few drops passing. Burning in the urethra. Tenesmus in the neck of the bladder. Passing urine cuts, smarts and burns; it is painful and slow, and the urine is sometimes bloody. Incontinence: cannot retain urine long. Urine albuminous, turbid. Tickling in the forepart of the urethra, with a feeling that something is about to run out.

Male

Burning in the urethra with erections. Atrophied testicles. Scrotum shriveled and drawn up. Desire is gone and the parts waste away, while nocturnal emissions are frequent and profuse. Sexual desire at first increased, then lost. Impotence, italicised in Boericke, is a leading indication in industrial and alcoholic broken-down cases.

Female

Atrophy of the ovaries. Labour-pains too weak. The female picture is thin, and the article does not extrapolate beyond what Boericke and Clarke record.

Back and limbs

Rheumatism with stiffness of the neck. Pains in the lumbar region and loins. E. Case's characteristic sensation is a weight between the scapulae that forces the patient to bend forward, with a throbbing in the dorsal spine that feels like a heart beating there. A sensation as if dislocated.

Emaciation. Paralysis. Trembling. Sore, bruised limbs. Oedema. Loss of sensation in the arms and hands. Sciatica. Cramps in the limbs. Pains like lightning, accompanied by cramps. Flying pains that keep coming back at regular intervals over a long period. Neuritis that progresses. Right-sided hemiplegia. Mechanical irritability of the muscles is markedly increased alongside the general wasting — the muscles waste while remaining irritable. Formication, and a tingling like an electric current. The lower limbs ache, with cramps and crawling sensations. The gait is unsteady and tottering, and worse in the dark. Tearing pains come and go in the limbs, first in one and then in another. The feet lose sensation. The fingers swell and turn numb, rigid and stiff. Herpes appears on the backs of the hands.

Skin

Anesthesia of the skin. Burning. Itching. Ulcers. Small wounds fester. Furunculosis. Long-standing skin complaints that itch a great deal. Red, raised eruptions on the face. Vesicles sitting on a swollen, inflamed, red base, containing an opaque, yellowish fluid; the vesicles dry to thick, yellowish scabs, and the discharge excoriates the skin and causes violent itching.

Herpetic diathesis. A tetter-like eruption on the left cheek, spreading and covered with yellowish-brown scabs, almost unbearable from continued itching. An eruption on the nose and cheeks similar to the acne of drunkards. Impetigo of the same excoriating, thickly-scabbing kind. This is the picture to which the dandruff page points for the intensely itching, oozing, scaly scalp of the broken-down constitution.

Modalities

Worse:

• warmth; warm rooms; warm applications
• at night
• slightest motion; walking
• during and after eating; after breakfast
• bathing
• tobacco, wine, beer, alcohol
• coal-gas fumes

Better:

• open air
• warm drinks
• deep respiration (chest constriction)
• eructations and passing flatus (stomach and abdomen)
• sweating (headache)
• evening and twilight (vision)
• after eating (vision only)

The seeming contradiction between "worse from warmth" and "better from warm drinks" is characteristic. External warmth aggravates the general state and provokes the toothache. Warm liquids taken internally relieve the stomach. Both belong to the picture, and neither cancels the other.

Relationships

Similar in action. Kali xanthate is similar in its action on cortical substance, in the loss of memory, in the marked blood degeneration, in impotence and senility. Tuberculinum and Radium sit in the same group of deep-acting nosodes and elements for broken-down constitutions.

Parents and cousins. Carbo-veg for the flatulence. Sulphur for the abdominal soreness and the worse-from-warmth. Causticum and China for the paralytic weakness and for shared indications in Meniere's disease. Salicylicum acidum stands alongside for the auditory neuritis and vertigo.

Eyes. Benzoinum dinitricum in the visual disorders. Thyroidinum where sight diminishes progressively, with a central scotoma.

Abdomen. Lycopodium shares the sensitiveness of the abdomen.

Head and throat. Anacardium hears voices as this remedy does. Cannabis indica shares an opening-and-shutting sensation in the head. Silica shares the sensation as if a hair had lodged in the throat.

Clinical Uses

Sciatica and peripheral neuritis

The remedy is at home where sciatica appears in a broken-down, cold, wasted constitution with anesthesia of the limbs, cramps, formication and tearing pains that flit from one limb to another. Lightning-like pains with cramps. Gait unsteady and tottering, worse in the dark. Progressive neuritis is the underlying process the remedy meets. Boericke and Clarke prescribe at 30C and upward; E. Case's cure was at 30C.

Dim vision and optic atrophy

Where sight fades, colours are lost first for red and green, and the visual field is seen as through a fog or a spider's web, Carboneum Sulphuratum is one of the remedies to weigh. Central scotoma. Optic disc cloudy, then pale, moving toward atrophy. The modality that vision is better in twilight and after eating is the fixing sign. Prescribing is constitutional, and the potency is chosen to the sensitivity of the case.

Tinnitus and Meniere's disease

Buzzing and singing "like an Aeolian harp" with impaired hearing. Vertigo. Sharp pain in the ears after stool. The remedy sits with Causticum, China and Salicylicum acidum in the relationships group for Meniere's disease, particularly where the disorder is of the auditory nerve rather than the middle ear. See the tinnitus page for the wider differential.

Toothache from warm food

The italicised keynote. Where cold relieves and warm food or drink in the mouth provokes the pain, the differential lies between Carbo-veg, Sulphur and this remedy. Neuralgia of the teeth in a patient with the wider anesthesia, tremor and broken-down constitution completes the indication.

Chronic skin disease with excoriating discharge

Vesicles rising from a base that is red, swollen and inflamed, containing an opaque yellowish fluid that dries to thick yellowish scabs, with a discharge that excoriates and produces violent itching. Herpes and impetigo. Herpetic diathesis. The remedy has its place in eczema and impetigo of the scalp and face where itching is nearly unbearable and small wounds fester. It is the reference to which the dandruff page points for the excoriating, scabby, oozing scalp of the broken-down patient.

Chronic effects of lead, coal gas and alcohol

Broken down by alcohol. Chronic lead poisoning. Ill-effects of coal gas. The remedy's industrial origin makes it a natural chronic prescription for patients whose damage traces to occupational or habitual exposure, and particularly where memory, sight and sexual function are failing together.

Frequently Asked Questions

How does Carboneum Sulphuratum differ from Carbo Vegetabilis and Sulphur? The three share the aggravation from warmth. Carbo-veg gives flatulence; Sulphur gives abdominal soreness; Carboneum Sulphuratum gives both, and adds a specific neurological picture the parents lack. Anesthesia of skin and mucous membranes. Peripheral neuritis. Progressive optic atrophy. Tremor of the whole body, marked in the hands. Where a Carbo-veg or Sulphur case fails to hold and the case is deeper, with nerves, senses and memory failing together, the compound is often the correction.

Which potencies are used? Two registers apply. In the industrial and dosimetric sense, carbon bisulphide is a neurotoxic solvent, and its dose-based data belong to the material world of poisoning studied by industrial physicians. In homeopathic prescribing, classical practice works at 30C and above; E. Case's reported cure of the slender nervous woman with the weight between the scapulae was at 30C. Higher potencies are reserved for constitutional cases with clear mental symptoms and marked sensitivity. Lower attenuations belong to acute industrial pictures where the pathology and its dynamic form nearly coincide.

Is this remedy safe? What about the toxicity of carbon bisulphide? Toxicological data on carbon bisulphide describe the industrial substance in the crude state, the fumes inhaled by nineteenth-century vulcanising workers that Crippen collected and Boericke drew on. At 30C and above no molecule of the original substance is present, and the pharmacological threshold cannot be approached even in principle. What acts is the dynamic preparation, prescribed on the totality of the case. The industrial pathology of the substance is precisely what makes the remedy indicated in patients whose damage resembles it.

What is the "six-week diarrhoea" and why does it matter? The periodicity of the remedy is six weeks, particularly for the diarrhoea. Periodicity is a constitutional signature. Complaints that return on a fixed calendar without external cause point to a deep-acting remedy. A patient whose gut, headache or skin follows this rhythm, with the other keynotes present, is the classical Carboneum Sulphuratum case.

References

• Boericke, W. Pocket Manual of Homoeopathic Materia Medica. Entry on Carboneum Sulphuratum.
• Clarke, J. H. A Dictionary of Practical Materia Medica. Entry on Carboneum Sulphuratum.
• Phatak, S. R. Concise Materia Medica of Homoeopathic Remedies. Entry on Carboneum Sulphuratum.
• Crippen, H. H. Case series of workers intoxicated with carbon bisulphide, published in the Medical Argus.