12 H2O) is employed under the name of alumen and more rarely aluminium metallicum. The effects of alumina and alumen are so similar that we will discuss the simpler and better proven Al2O3, and mention the peculiarities of alumen only incidentally. The trivalent element Al is an earthy metal and stands at the transition from the earthy alkalies to the heavy metals. APPEARANCE AND SIGNIFICANCE IN PLANTS AND ANIMALS Aluminium in the form of complex silicates forms over 7 Percent of the earth’s crust. In clay and loamy soils it is even more abundant. Many plants take it from the soil. The lower plants as mosses (lycopodium) and ferns are richest in aluminium. The hygrophytes with considerable water exchange contain more aluminium than the xerophytes in which the water maintenance and transpiration is difficult. According to Stoklasa aluminium wanders through the membrane and prevents the exit of biogenic elements employed.
Of Group III of the periodic system only boron and aluminium have medicinal significance. Both are lithophilic elements. Both are positive trivalent.
Group III cannot be designated as the earthy metal group because the initial member, boron, has essentially non-metallic properties. As happens so often the lightest element of the group takes an exceptional position chemically. The great gap which seems to exist between the elements boron and aluminium becomes smaller when one considers the similar behavior of some of their compounds. And in the effects which their oxygen compounds unfold in conjunction with the living organism, the group relationship becomes still more distinct. However the boron compounds are much milder compounds than the aluminium compounds. Likewise the protein precipitation by aluminium is even less reversible than that of boron. This relationship is evident to some extent in the familiar local uses of boric acid and the acetate of aluminium. As an antiseptic boric acid and is even milder than the solution of the always weaker aluminium acetate. In the double sulphate salts, alum, aluminium has distinct general astringent actions on the tissues. Likewise the total action of boron compounds (as borax) is essentially milder than those of aluminium (for example, aluminium oxide), but the similarity of their trends of action is unmistakable.
The aluminium preparation which comes chiefly under consideration for us is aluminium oxide, Al2O3, which is designated in the materia medica as alumina. However alum, the double sulphate salt of potassium and aluminium (KAl(So4)2 + 12 H2O) is employed under the name of alumen and more rarely aluminium metallicum. The effects of alumina and alumen are so similar that we will discuss the simpler and better proven Al2O3, and mention the peculiarities of alumen only incidentally.
The trivalent element Al is an earthy metal and stands at the transition from the earthy alkalies to the heavy metals.
APPEARANCE AND SIGNIFICANCE IN PLANTS AND ANIMALS
Aluminium in the form of complex silicates forms over 7 Percent of the earth’s crust. In clay and loamy soils it is even more abundant. Many plants take it from the soil. The lower plants as mosses (lycopodium) and ferns are richest in aluminium. The hygrophytes with considerable water exchange contain more aluminium than the xerophytes in which the water maintenance and transpiration is difficult. According to Stoklasa aluminium wanders through the membrane and prevents the exit of biogenic elements from the cell. Thereby the cells cannot be plasmolysed. Aluminium in the plant cell membrane increases the swelling of the cellulose very markedly, the intake of water makes easy and limits or prevents the incorporation of metals as iron and manganese, perhaps, also calcium and potassium. In the plant aluminium is also an important regulator of membrane permeability for water and ions. In the animal body it is present in large amounts only in the lower forms, such a smedusa, otherwise only in traces. Since it is ingested with the plant foods, this speaks against the absorption of aluminium from the intestine. Actually resorption effects of aluminium from the intact intestinal wall are denied. The toxic actions described of the salts are provoked either by intravenous injection or are local in nature. Aluminium coagulates protein, but the precipitation under some conditions is reversible. Thus water plants whose protoplasm is coagulated by aluminium can grow again when they are placed in their original medium.
With this property is associated the employment of aluminium as a mild corrosive, astringent and mild antiseptic, which is generally known and commonly used. One need only think of aluminium acetate, Liqu. alumin. acetat. Apart from the protein precipitation, for the stronger corrosive action of burnt alum (in which the water of crystallization is driven out by heat) its hydroscopic effect comes into consideration. In the school in any case alum is employed in a weak solution in diarrhoea, and here just as on other mucous membrane catarrhs by virtue of a direct local action. Moreover aluminium is also present in the related Neutralon employed in acid dyspepsias. Even in his Apothecaries Lexicon Hahnemann mentioned that alum earth seems to be a suitable remedy in the gastric weakness provoked by acids and in diarrhoea due to relaxation of the alimentary tract. Moreover in small doses alum produces gastric irritation and vomiting, larger amounts leading to fatal gastro-enteritis.
INTOXICATIONS AND ANIMAL INVESTIGATION
In a case of poisoning Ricquet observed severe difficulty in swallowing, tormenting thirst, vomiting of blood, and constipation; moreover twitching of the muscles, spasms, anxiety, finally accelerated and irregular pulse, rapid respiration, repeated attacks of fainting, collapse type of temperature and finally death. In addition to these manifestations, Kramolik saw albuminuria, hematuria, and casts.
P. Siem first studied the actions of aluminium by injecting double aluminium salts in frogs and mammals, thereby avoiding the gastro-intestinal canal. After injection of sodium-aluminium lactate in frogs (lethal dose 0.02-0.03) he observed at first severe restlessness and then hour-long rest in a normal position; thereafter the movements be came uncertain and lethargic, the animal lay flat on the abdomen, reflex irritability was diminished and finally fell to zero. Then paralysis of respiration appeared and finally cardiac standstill in diastole. Nerves and muscles still react after death. Siem injected the citrate and tartrates of sodium-aluminium in small continuous doses (lethal dose about 0.15 pro. kg.) of about 0.25-0.3 Al2O3 into dogs, cats and rabbits. During a trial continued for a week nothing is noted at first; after 344 days loss of appetite, constipation, decrease in weight, lassitude, inertia, and vomiting appeared. The apathy continually increased; trembling and convulsive twitching appeared: the animal was almost completely devoid of sensation. The tongue could not be moved and there was a flow of saliva. The temperature was very low. The death occurred at times with special phenomena, at times with clonic spasms consequent to respiratory disturbances. Autopsy shows: hyperemia of the gastric and intestinal mucosa with single small ulcers, the large intestine is normal; the liver shows fatty degeneration; there is parenchymatous swelling in the kidney.
Of particular interest for us is that Siem believed he saw the picture of a chronic bulbar paralysis in the symptoms. Outside of the influence on the columns of the spinal cord and the medulla, in respect to the homoeopathic drug picture there is the delayed appearance of the action (in spite of massive doses) and also the constipation. The symptom of flow of saliva perhaps is to be considered as the secondary result of a paralysis of the tongue.
The results of Dollken differ from those of Siem in some respects, above all in that he found smaller doses fatal, rabbits dying suddenly 12-25 days after single doses of 0.015 g. pro. kg. aluminium-sodium tartrate. Again worthy of note is the long delay of stimulus. In injections of 5mg. pro. kg. subcutaneously there was a loss of weight after 6-8 days and after 14-35 days death without particular manifestations. In cats after subcutaneous injections of 2-5 mg. Al2O2 pro. kg. twice daily Dollken saw: after some days decrease of weight, loss of appetite, soon also decreased movements of the tongue and dragging of the posterior extremities; if they were again injected then depression, salivation, stiffiness of the extremities appeared, then twitching in these and pendulum movements of posterior half of the body; the tongue was always hardly moved, there was huskiness, increasing dullness and clonic spasms. Later the irritation phenomena ceased, the animal showed spastic paralysis and fibrillary twitching so that spontaneous progression was impossible. From the beginning there was constipation as a rule, the stools contained mucus or blood. With increasing intoxication sensitivity diminished, the anterior musculature showed tonic or clonic spasms, the posterior were paralyzed. 2-3 days before death the blood pressure is very low, the vagi hardly can be stimulated. Death may occur in convulsions or may be gradual. Dogs react like cats. The microscopic investigation of the central nervous system is reported by Dollken: constantly a turbidity of the pia over the convexity of the brain, often venous hyperemia of the brain and spinal cord. Neither systematic degeneration of the cord nor any myelitic foci to any extent were found in any case. In the white substance of the brain no alterations, relatively little in that of the cord. In the spinal cord slight column degeneration at the decussation of the pyramidal tracts, in the cervical cord somewhat more marked degeneration in the lateral and posterior columns, in the thoracic cord only very little, in the lumbar cord marked degeneration of the posterior columns, particularly in those parts which lie in the medium aspects of the anterior root zone and corresponding to the column of Goll, the nerve roots of the V, VII, XII were more than half degenerated, IX, X, XI contained degenerated fibres; anterior and posterior roots of the cervical enlargement of the cord largely degenerated, bronchial plexues hardly at all; anterior and posterior roots of the lumbar enlargement in part markedly degenerated, ganglia cells are at times markedly degenerated, glassy, granular, destroyed and show nuclear degeneration.