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. Murphy notes that the remedy has "a deep and disorganizing action and an immense range of action and symptomatology," and the historical dose covers all 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, Clarke and Murphy.

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 frontal pains and heaviness of the head. Painful contraction of the masseters followed, then stiffness of the neck and vertebral column, and finally of the legs and arms. The jaws could not be separated. Ulcerative stomatitis ensued, 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.

All potencies are used in prescribing. Murphy records E. Case's cure with Carboneum Sulphuratum 30C in a slender, nervous woman for a sensation of a weight between the scapulae compelling her to bend forward, throbbing in the dorsal spine as if a heart were beating there, constipation with ineffectual urging to stool, and bright blood from the rectum after stool.

The Essence of Carboneum Sulphuratum

The remedy meets broken-down, weak constitutions. Murphy italicizes the phrase lack of vital heat as 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. Murphy's commentary fixes it 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.

Oversensitivity to noise. Fear while walking in the dark. The delusions circle around persecution and injury. The patient believes himself surrounded by enemies. He believes he is about to receive an injury. He talks of money in his delirium. He hears voices. One of Crippen's patients was convinced he had committed a robbery. Another felt a hole close by into which he was in danger of falling.

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. A suicidal disposition, 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

Headache as from a tight cap. 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, Clarke and Murphy all 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 seems in a fog, as if a spider's web lay over things. 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. Retinal congestion. Arteries and veins tortuous, veins distended, 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 with complete right-sided hemiplegia following sudden loss of consciousness, blindness of the right eye and great impairment of the left.

Ears

Ringing in the ears with poor hearing. Noises in the head. Deafness as if the ears were obstructed by a fixed substance. Buzzing and singing "like an Aeolian harp," an image Murphy preserves in the EARS section. Sharp pain in the ears after stool. Pain in the left ear on swallowing. Sharp pain in the right ear. The remedy takes its place in the differential of tinnitus and of Meniere's disease.

Mouth and teeth

The italicised keynote: toothache brought on by warm food. 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. Lisping, stammering speech like that of a child. Ulceration of the lips. Lips blue, moist, with convulsive movements. 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 causes violent dry cough. Sensation 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. Scraping feeling with fine stitches. Goitre. Voice feeble, of a deep tone. Hoarseness. Irritation to hawk. 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. Flying sharp pains and burning in the chest, quickly passing over, frequently returning. Oppression and fullness. Constriction as if expiration were impeded, better from deep respiration, better in open air, worse ascending steps. Warmth and fullness in the chest with difficult breathing. Expiration hot. Emphysema. Asphyxia from alcohol or coal gas.

Sneezing with sensitiveness in the chest. Cough from irritability of the larynx. Cough after lying down. Cough from tickling in the posterior palate that strains the chest and makes 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, better after eructations or vomiting. Vomiting of food with glairy mucus. Vomiting of bitter water. An inclination to vomit when entering a room or going into the open air.

Ravenous appetite, then lost. Hunger with aversion to eating. Great thirst. Desire for beer. Aversion to meat. Worse from tobacco, wine and beer. Worse from alcohol. Drunken, unconscious from whiskey. The remedy's affinity for cases broken down by alcohol finds its stomach here.

Abdomen distended, with soreness and rumbling. Flatulence better after stool. Twisting, rolling and rumbling as if diarrhoea would set in. Cutting pain in the bowels. Abdominal walls as if bruised. Pain with wandering swellings as from flatus, a sensation of a moving lump beneath the wall. Navel drawn inward with pain. Strangulated hernia. Griping around the navel with urging to stool. Liver troubles with edema of the feet.

Rectum and stool

Itching and burning at the anus. Constipation with belching. Constipation with 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. Cutting, smarting and burning during urination. Urination painful and slow, sometimes with bloody urine. Incontinence: cannot retain urine long. Urine albuminous, turbid. Tickling in the forepart of the urethra with a sensation as if something would run out.

Male

Burning in the urethra with erections. Atrophied testicles. Scrotum shriveled and drawn up. Desire lost. Parts atrophied. Frequent and profuse nocturnal emissions. 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 in the source, 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 of a weight between the scapulae, compelling the patient to bend forward, with throbbing in the dorsal spine as if a heart were beating there. A sensation as if dislocated.

Emaciation. Paralysis. Trembling. Sore, bruised limbs. Oedema. Anesthesia of arms and hands. Sciatica. Cramps in the limbs. Lightning-like pains with cramps. Flying pains returning regularly for a long time. Progressive neuritis. Hemiplegia of the right side. Murphy notes a "strong increase of mechanical muscular irritability" alongside the general wasting — the muscles waste while remaining irritable. Formication, tingling as from electric currents. Pain in the lower limbs with cramps and formications. Gait unsteady, tottering, worse in the dark. Tearing in the limbs, coming and going, now in one, again in another. Feet insensible. Fingers swollen, insensible, rigid, stiff. Herpes on the dorsal surface of the hands.

Skin

Anesthesia of the skin. Burning. Itching. Ulcers. Small wounds fester. Furunculosis. Chronic skin diseases with much itching. Eruptions on the face, red, elevated. Vesicles on a red, inflamed and swollen base, containing an opaque, yellowish fluid; the vesicles dry to thick, yellowish scabs, and the discharge excoriates and produces 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. Murphy's relationships list Kali xanthate as 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 in progressive diminution of sight with 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 on a red, inflamed and swollen base, 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? Boericke gives "all potencies." 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? Murphy fixes the periodicity of the remedy at 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.
• Murphy, R. Nature's 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. Cited in Murphy's commentary on the remedy.