PHOSPHORUS


Homeopathic remedy Phosphorus from A Manual of Homeopathic Therapeutics by Edwin A. Neatby, comprising the characteristic symptoms of homeopathic remedies from clinical indications, published in 1927….


      The element phosphorus. (P) Atomic weight 30’96. Saturated solution in absolute alcohol. Trituration of red, amorphous phosphorus.

PATHOGENESIS AND PHARMACODYNAMICS.

      PHOSPHORUS is very insoluble in water and the body fluids and is therefore absorbed with difficulty when taken in mass, but if dissolved in oil or fats, or when finely divided, it causes symptoms even though administered in very small quantities, and has induced fatal poisoning in man in doses as small as two grains. The vapour of phosphorus is absorbed by the lungs, and it is thought that in chronic poisoning in lucifer match factories the poison gains admittance to the system by this route. Phosphorus does not penetrate the skin and phosphorus burns do not cause phosphorus poisoning. The red, amorphous phosphorus, which is less volatile and also less soluble, does not cause poisoning in the factories in which it is used. Phosphorus when absorbed into the blood produces its effect by its own presence and not through any compounds it may form; when oxidized it loses its specifics properties. It does not act on albumins in solution and has no local irritant effect on the tissues, such as occurs, for instance, with arsenic.

When a poisonous dose is taken nothing happens for several hours, then pain is felt in the stomach with nausea and eructations, which are phosphorescent in the dark, and taste of garlic; later, there is vomiting of bile and perhaps diarrhoea. These symptoms may continue but frequently disappear and for a few days nothing noticeable occurs. Then a second stage comes, vomiting and diarrhoea recur but the vomiting is now of bloody mucus and does not taste or smell of phosphorus as at first, the pain is greater and extends to the liver region and there may be some jaundice. The patient is weak and faint with a small, thready pulse, the liver is enlarged and tender and extends below the ribs, the urine contains fatty casts, blood and hemoglobin, possibly albumin, and there is increased excretion of nitrogen in the form of lactate of ammonia, leucin, tyrosin and also of phosphates, and, if there is jaundice, of bile pigment. Haemorrhages occur from the mucous membranes and under the skin. Finally, collapse and fatal coma come on. In many cases convulsions and delirium occur towards the termination of the poisoning.

“Phossy jaw” is due exposure to the fumes of phosphorus, which gain admission through carious teeth or some lesion of the gums and set up periostitis, which advances rapidly to necrosis of the bone, most markedly in the lower jaw. The prolonged suppuration and hectic fever which result often lead to death from exhaustion. The fumes of phosphorus may also give rise to chronic poisoning, apart from any affection of the jaws, the symptoms of which are cachexia, anaemia, albuminuria, chronic enteritis, bronchitis, and an affection of the bones that causes them to be unusually liable to fracture. That phosphorus fumes cause lesions in other bones that the jaws, lesions that do not proceed to necrosis, makes it probable that necrosis of the jaw when occurring is due to the combined action of phosphorus and of micro-organism which gain access through the carious teeth and injured gums; the subacute periostitis caused by phosphorus is a favorable site for the action of the micro-organisms.

Phosphorus produces fatty infiltration of the cells of many organs, notably of the liver, kidney, gastric and intestinal glands and the muscle fibres of the heart, stomach, intestines, arterioles and often of the skeletal muscles. This does not occur till the second stage of poisoning and is the cause of the symptoms then displayed. The fat in the cells is not formed, as formerly believed, by degeneration of the proteins of the cells in which it is found, but is ordinary fat transported from the positions it normally occupies. The cells in which the fat is deposited eventually degenerate and break up into detritus, so that, though it is primarily an infiltration of fat into the cells that takes place, the term “fatty degeneration,” as applied to the tissues, is not inappropriate.

When phosphorus attacks the liver with extreme violence the condition of “acute yellow atrophy” is produced, a disease of the liver exactly resembling that sometimes caused by chloroform poisoning, and is rapidly fatal. In less severe attacks the liver is first enlarged from swelling of its cells but afterwards contracts owing to destruction of many of the cells, and to proliferation and subsequent contraction of the interstitial connective tissue which occurs as a secondary result of such destruction. Cirrhosis results. This happens not alone in the liver, but also in the stomach and kidneys and is the cause of many of the symptoms occurring in chronic poisoning by phosphorus. This drug alters the functional activity of the liver and prevents the complete oxidation of glycogen, fat and the non- nitrogenous results of protein breakdown, increased quantities of lactic and other acids accumulate and for their neutralization combine with ammonia which, with leucin and tyrosin, is produced in unusually large amount. These are derived from excessive protein metabolism due to phosphorus increasing the activity of the autolytic ferment of the liver.

Phosphorus weakens and slows the heart by the gradual production of fatty degeneration in its muscle fibres, and the fatty degeneration of the muscular coat of the smaller arteries throughout the body is the main cause of the haemorrhages that occur, though a lessened ability of the blood to clot, through deficiency of fibrinogen, may be a contributing cause.

The cells of the central nervous system and those of the peripheral nerves do not seem to be influenced directly by phosphorus, at least no gross changes occur in them and consciousness is preserved almost to the last, but the disordered metabolism, the haemorrhages and the altered function of stomach, liver and kidneys lead to many symptoms of a disordered nervous system. It is probable that phosphorus may in some cases act as a food to nervous tissue, of which it normally forms 1 per cent., when there is a deficiency of that substance in the nerves, in the same way as iron does to the blood when there is a deficiency of hemoglobin in the red cells.

At post-mortem examinations in cases of phosphorus poisoning the blood-vessels of the pia mater were congested with blood, and yellow, opalescent lymph was found collected between the pia and arachnoid; the grey matter was softened.

When phosphorus is given in minute doses it acts as a stimulant to the osteoclasts. Whenever cancellous bone is being formed in cartilage it causes at the growing point the deposit of a layer of dense bone, while at the same time the soft cancellous bone deposited before the phosphorus was taken is gradually absorbed. Consequently the medullary cavity of the bone is enlarged and may extend into the epiphyses. A similar process of absorption occurs in turn in the dense bone formed at first under phosphorus while fresh dense bone is formed in front of it. The Haversian canals are narrowed and the blood-supply to the bone is diminished. Bone deposited from the periosteum shows the same phenomenon. The red corpuscles, in chronic poisoning, are at first increased in later this degenerates and both red and white corpuscles are numbers from stimulation of the activity of the bone-marrow, diminished. In pregnant animals poisoned with phosphorus the drug passes through the placenta, as shown by the foetus undergoing fatty degeneration. The hear is not seriously affected till very late, when fatty infiltration and degeneration occur.

THERAPEUTICS.

      The above is a short summary of the pathology of phosphorus poisoning, which underlies the vast array of symptoms to which the drug gives rise, which symptoms will be most conveniently considered in relation to the diseases for which fatty degeneration of the cells of so many organs and tissues gives it a very wide range of action, and makes it a suitable medicine for many diseases, but, as in the case with all the polychrests, it has certain characteristics of its own that should d be evident in any particular case to ensure confidence in prescribing it. Though phosphorous has no specific pathology of nerve cells, it nevertheless has some noteworthy nervous and mental symptoms.

Mind- The patient suitable for treatment with this remedy is hypersensitive, easily excited by emotional impressions, such as arise from lively company, grief loss of friends or enthusiasm for a cause, but he does not bear the excitement well, suffers from it afterwards and is alternately depressed and apathetic, and these tend to become the dominant moods. He is fearful of many things, afraid of the dark, of being left alone, of things creeping out of corners, respecting the issue of his disease, of thunderstorms. He seems to be physically affected by thunderstorms, and to be very sensitive to electric states of the atmosphere. Many a person accustomed to be in a state of terror during thunderstorms has been enabled to pass through them calmly after treatment with phosphorous. There are anxiety and apprehension, which are often associated with a sensation as of fear at the pit of the stomach, the patient is prostrated buy the least unpleasant impression, or comes over in a heat “as if immersed in hot water,” with perspiring head and hot, perspiring hands, from anything that excites him. He has lascivious thoughts that excite a great desire for sexual intercourse, with corresponding orgasm of the sexual organs, which afterwards gives place to importance, though the mental excitement remains. He may be aroused to anger and violence by anything that vexes him. Anxiety and restlessness are worse at twilight and may be accompanied by palpitation. He is restless over and cannot keep still, and is especially fidgety in the hands. Excitement gives place to lethargy, to a feeling of indifference, to forgetfulness and an inability to fix the mind, and finally to stupor, from which he can be momentarily roused. With stupor there may be low muttering delirium and picking art the bedclothes.

Edwin Awdas Neatby
Edwin Awdas Neatby 1858 – 1933 MD was an orthodox physician who converted to homeopathy to become a physician at the London Homeopathic Hospital, Consulting Physician at the Buchanan Homeopathic Hospital St. Leonard’s on Sea, Consulting Surgeon at the Leaf Hospital Eastbourne, President of the British Homeopathic Society.

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,