Manganum aceticum [Mn (C2H2O2). 4H2O]. Manganum carbonicum (MnCO32). Solutions of the acetate and chloride. Manganum muriaticum (MnCl2). Manganum oxydatum (MnO22). Triturations of the carbonate and oxide (black oxide of manganese).
PATHOGENESIS.
THE salts of manganese when given in large quantities cause acute irritation of the stomach and intestines, like those of the other heavy metals. Workmen engaged in chemical works, where grinding the black oxide was carried on, became chronically poisoned through breathing the fine dust with which the air was loaded, and from swallowing small quantities with the food. Symptoms of paralysis slowly came on, first in the lower extremities, shown by staggering gait an an inclination to run forward when attempting to walk, there were twitching of muscles and cramps, some stiffness or spasticity, and increased tendon reflexes. The arms were affected in a less degree. The acetate is said to cause fatty liver and jaundice, also nephritis and albuminuria. The voice was weak, so that the patients could not make themselves heard at a moderate distance, but there was no difficulty in articulation. Psychical manifestations preceded the above symptoms, such as hysterical laughter or grief, languor and sleepiness. There was no deficiency in sensibility or intellect, but there was evident an expression of vacancy in the countenance, probably from paresis of the facial muscles. These symptoms are attributed to lesions of the basal ganglia of the brain, and when fully developed no recovery takes place, although the patient may live for years. The binoxide in workers produces bulbar paralysis. The salts o manganese cause cirrhosis of the liver and jaundice, and also albuminuria and nephritis.
Mind.- The less serious symptoms elicited by the provers are great apprehensiveness, with a feeling that something dreadful is going to happen, the patient walks the floor in his anxiety, but only gets worse, he tries to occupy his mind with work, but it is of no use, but when at last he lies down and keeps quiet the restlessness and anxiety pass away. Involuntary laughter and weeping may be present.
Head.- The head feels heavy and congested, movement jars the brain painfully, drawing and stinging pains are felt in the forehead and sides of the head, and there are pressing or bring pains which seem to be located in the skull bones. Those headaches which come on in a room are relieved by going into the open air and vice versa. a cold sensation is experienced over a small spot on the vertex.
The eyes ache from looking at a near object or at a bright light.
Nose.- The bones and cartilages of the nose are sore and tender, worse in cold damp weather.
Ears.- The ears are painful to touch, there are soreness, rawness and burning in the auditory canal, scratching the meatus causes a spasmodic cough (kali carb., silic.) and there is a ” feeling of a leaf before the ear.” The ears are the seat of pains coming from other parts; thus pains in the throat and teeth shoot into the ears, movements in the larynx, such as talking, cause itching in them. There are whizzing noises in the ears with dull hearing, which is worse during cold and rainy weather and is better from blowing the nose. The face is pale and sunken and has a sickly appearance and an expressionless mask-like aspect, the zygomata are tender and twinging stitches are left from the lower jaw to the temples when laughing.
Digestive Tract.- The lips are dry, parched and shrivelled, there is smarting toothache, made intolerable by anything cold touching the affected tooth, or there may a violent toothache which suddenly shoots to the ears, or the pain leaves the tooth and settles in the arm.
The throat is sore, nausea and eructations of air occur with a dull pressure or a cutting pain in the stomach, made worse by external pressure. Stitches are felt in the liver region, likewise worse from pressure, and cutting pain with rumbling in the abdomen, worse from eating cold or iced food. The bowels act regularly and the stools are hard and retarded, of reddish-brown colour, or they are liquid, bright-coloured and followed by cutting pain in the umbilical region.
Urine.- There is frequent desire to urinate and the urine is increased in quantity; albuminuria.
Sexual.- The menses are too early and too scanty and are accompanied with bearing down pains; they usually do not last more than two days or may be absent.
Respiration.- Manganum has a special influence on the larynx; it causes weakness or loss or voice and hoarseness, which are worse from every spell of damp weather. The larynx feels raw, there is a constant accumulation of mucus in it which gives rise to continuous hemming (arg. met., phos., sil., sulph.), each hem bringing up a mouthful of mucus. The manganum cough is relieved by lying down (arg. met., euphr., ferr.), and is aggravated by talking, laughing, deep inspiration and cold, damp weather.
Limbs.- In the limbs manganum causes tearing, squeezing bruised and pressing or boring pains in the bones and joints, especially in, or in the neighborhood of, the shoulder, knee-or ankle-joints; a hard pressure in the muscle of the left leg just above the ankle-joint is a well-marked symptom. The bones of the feet feel as if forced asunder and the patient can bear no weight on his heels. Red, shiny swellings appear in the skin over the bones, especially over the tibiae, which are worse from touch, movement and at night. The joints are not much swollen and the pains in them shift from joint to joint, usually crosswise. There is great soreness of the periosteum; everywhere there is soreness from touch and from jarring. Bones and joints become inflamed at night with insupportable digging pains. Bruises remain sore a long time. Ulcers form slight injuries, suppurate and infiltrate with a purple hardness.
Skin.- There is burning in small red spots on the chest, arms, hands and feet. Single nodes form in the palate, and bluish nodes in the skin.
Chill, Fever, &c.- Sudden flying heats with redness of the face and without thirst occur, especially when standing, and they soon pass off. The patient is generally chilly in the evening. He has night sweats, accompanied with itching and vivid dreams that are well remembered.
THERAPEUTICS.
The symptoms of paralysis observed in the workers chronically poisoned by black oxide of manganese dust are so like those of paralysis agitans and of the similar state seen sometimes as a sequel to “sleepy” sickness (encephalitis lethargica) that manganum should be a curative remedy in these conditions if given before irretrievable damage has occurred.
Hahnemann in his preface to manganum in the ” Materia medica Pura” says : ” it will be found to be very efficacious, especially in some intolerable pains in the periosteum and joints, diminution of the senses and diseases of the larynx and trachea.” he adds : ” Many alternating actions will be found among its symptoms.”
Respiratory.- In homoeopathic practice it has been used chiefly in laryngeal affections for laryngeal catarrh with a weakness of voice and constant hawking of mucus, when the catarrh recurs frequently with every change to wet and cold weather, a condition that may precede tuberculosis of the larynx. It is useful for boys and girls when the voice is changing and remains harsh and hoarse, with continual clearing of the throat, also for speakers and singers who are always “hemming” and expectorating. It relieves the cough of laryngeal tuberculosis when the larynx is raw and sore, the voice husky or gone and the cough worse in cold, damp weather and from any movement of the larynx, such as that caused by talking and laughing, and relieved by lying down.
Manganese has been used by both schools instead of iron in anaemia and chlorosis with loss of appetite and gastric symptoms; the patient is waxy and pallid and is threatened by phthisis, or there may be caries or necrosis of bone.
Sexual.- If the subject is a young girls the first menses will be delayed till she is 18 or 20 and will then be scanty and too frequent.
Limbs.- manganese is a remedy to be thought of out chronic rheumatism that shifts from place to place, when the pains are worse at night and are felt principally in the bones and when the joints are very little swollen. Some of the lesions induced by manganum call to mind cases of erythema nodosum, for which it may prove useful.
Ears and Eyes.- It is one of the principal medicines for catarrhal conditions of the ears, with increasing deafness set up by every fresh attack. There are catarrh of the Eustachian tubes and burning and itching in the auditory meatus, “whizzing” noises are heard and the ears are painful to touch. The deafness is better from blowing the nose. Manganum is of service to relieve pain in the eyes brought on by too fixed a concentration on near objects, such as in sewing and reading fine print.
Digestion.- It has been used for indigestion, worse in cold, damp weather and relieved by bending double; to ward off tabes mesenterica and when there is tendency to fatty degeneration of the liver; also for jaundice or gall-stones.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,