Since the diastolic blood pressure sinks under calcium action, an increase of the stroke volume and increase of cardiac work may be assumed. Actually in the cat the amount of blood circulating after injection of calcium has been found increased.
The positive inotropic action of calcium, the reduction of the pulse rate, sinus bradycardia up to arryhythmia, and disturbances of conduction up to sion-auricular block (in contrast to the naturally slight increases of frequency in animal investigation, similarly in pathologic hearts in men!) furthermore the lowering of diastolic pressure, enlargement of the stroke volume, all make the acute calcium ion action approximate the digitalis bodies closely. (Compare Weizacker, Loewi, v. Konschegg, Billigheimer. Loewi perceives strophanthin action as a sensitization of the heart for calcium ions. In all cases reacting to strophanthin, the capacity of the heart to the demand of the stimulus of the physiologic blood calcium is reduced, and therein lies the cause of defective cardiac function.
According to all, the calcium influence on the heart is better conceived as a vagus action (which also corresponds much more to digitalis!) than as a sympathetic action as S. G. Zondek states. But one cannot ascribe the calcium action in general to either the vagus or the sympathetic alone. It is well to consider that the increase of resistance, which indeed is also here the chief action of calcium ions, is effective not only on the muscle cells but also on the vegetative cardiac nerves. In any case calcium is necessary for the electrical excitability of the vagus as well as for the sympathetic.
Small doses of calcium increase the irritability of the vagus. Large doses of calcium should pervert the vagus irritability so that electrical excitation induces an acceleration. With a calcium defect the vagal nerve endings on the frog heart are indeed sensitive to adrenalin.
On the isolated intestine the presence of calcium is necessary for the action of sympathetic stimulant poisons (adrenalin)as for vagus poisons (acetylcholin). In high-grade calcium defects, the intestine in experiments becomes almost non- sensitive to potassium and sodium ions as vagus excitors as against muscarine. In general, on the stomach -intestine a sympathetic action is also considered, a depression of the motor and secretory functions. But this agrees in no way with the experimental findings; in dogs the motor activity of the gastric musculature should be weakened by calcium but the secretion increases from rectal injection of calcium and is lessened from intravenous injections; the after-effect of perorally and rectally administered calcium shows always an increased gastric secretion. In man, after the intravenous injection of CaCl2, the secretion of the stomach is mostly increased and also the modality. These are also vagus effects.
That a simple relation of calcium equals sympathetic excitation cannot be accepted also proceeds from experiments on the surviving human uterus. Gravid and non-gravid uteri behave opposite to shifting of the Ca: K ionic proportions.
While the adrenalin sensitivity (that is, a sympathetic irritability) of the non-gravid uterus is depressed by an excess of calcium gravid uterus will be stimulated by adrenalin through an excess of calcium. For potassium excesses under the same conditions, the opposing action is seen. Here it also depends upon the preceding status of the organ whether the calcium excesses favors or depresses the sympathetic stimulus of adrenalin.
It is wrong to unite the calcium effect with a part of the vegetative correlative system as the sympathetic. The presence of calcium ions is necessary for the function of the sympathetics as for the parasympathetics. In order to establish the task of calcium ions, one must proceed from the receptive organs.
They may be conceived uniformly as an insertion of resistance against the otherwise unrepressed exchange of colloidal electrolytic charges. Without the calcium resistance the continuous excitation of the cells and their ferment-like subsystems rapidly proceed up to an end state of non- irritability. The calcium resistance is a partial function of the cations, and therefore calcium seems for many effects as the antagonist on Na and K, and or single effects as the antagonist of Mg ions. The physiologic resistance represents first the potential which is a precondition for the utilization of cell energy in the regulated course of living events. One never sees any sympathetic stimulus effect of calcium which would be represented metabolically in increased dissimilation and would proceed over the endocrine glands supplied by the sympathetic (thyroid, adrenal). Likewise, the tonic action, a sort of sympathetic stimulation, has been gained for the most part only experimentally in excised organs and cold- blooded animals, and this stimulation one can conceive just as well as a vagus depression. Whether stimulus or depression results is dependent, upon other conditions, in particular the dose.
The influence on metabolism through calcium is indirect. The tonus of cells will be determined through calcium, and the vegetative regulative state of the cells is again significant for metabolism. The increase of resistance in the cells through calcium will come into expression as a slowing of metabolism, a decrease of dissimilation. Actually the excretion of nitrogen in the urine is lessened by large doses of calcium; the protein balance becomes positive. This perhaps can be explained through the thickening of the cells and the capillaries simply in the kidneys. The lessened excretion through the kidneys under the influence of large doses of calcium is observed with many substances. The water and sodium chloride excretion is influenced by calcium in diverse ways: large doses of calcium increase diuresis after an initial fall, small doses depress diuresis. The sodium chloride excretion, in general, seems increased in consequence to an ion-shifting by calcium enrichment.
In disturbances and stasis in calcium economy, accordingly, we may expect, in consequence to the pathologically increased resistance, a slowing of dissimilative processes. The oxygen consumption is reduced to below normal. This is significant for the constitutional type of calcium.
The action of calcium ions on the body colloids plays an important role in the process of coagulation. So no coagulation of the blood can occur without the presence of soluble calcium salts. Probably the pre- stage of the fibrin enzyme is activated only in the presence of calcium salts. Also for the coagulation of paracasein (cheese) from milk through the ferment, rennin, and indeed its precipitation in solid form, the presence of calcium salts is necessary. It is concerned with the discharge of electronegative colloids by Ca.
Likewise if the presence of calcium is necessary for the coagulation of blood, still this does not say that increase o;f calcium ions promotes the capacity for coagulation. Indeed, this is debated at present and the increase of coagulation capacity is assigned to the bond calcium fraction of the blood. It is well known from clinical observations that calcium reduces the tendency to hemorrhage. But it is not certain whether this occurs through increase in coagulability or through thickening and contraction of the vessel or both.
Calcium salts increase the motility and phagocytic activity of the leukocytes. This is as important for the calcium effect on the inflammatory process as the thickening.
The influence of calcium salts on the blood is not reported uniformly. After CaCl2 injections, an increase in the lymphocytes and monocytes and decrease of the neutrophiles may be found; with KCl injections, the distributions are reverse. This can be correctly traced to an influence on the vegetative regulation. Completely uncertain is the influence of calcium on the red-blood-cell picture.
If the investigations on single organs and cells give us the first glance into the how’ of calcium actions, then we may more closely approach the disturbance of calcium economy and its regulation in the total organism under what conditions, in what disturbances and with what prospects can calcium salts be used therapeutically?
The calcium economy has its broad basis in the skeleton because here 99 per cent of the calcium is anchored. For this reason the marked outpouring of calcium cause distinct manifestations in the bones.
The tissue reactions of calcium are then best viewed in the bones. But calcium economy can only be considered in relation to the phosphate economy. Not only is the phosphate the most important supplementary anion to calcium but it takes a leading role in the movement of calcium, both in the introduction and exertion, and participates extensively in the important matter of state of form.
Calcium is deposited in the matrix of the bones in the form of a complex CO3 and PO4 compound of the type of appetite. The calcium salts are certainly not to be considered as a simple deposit but stand in close relation to the living tissue. Only in dystrophic classification does a simple deposition come into question. The process of calcification probably consists at first of an absorption union of the complex calcium salts of the serum by the cartilage colloids. For this an increase in phosphate in the serum is necessary, because only in such a serum does union follow only in the cartilage and not in the remaining tissues. In the growing cartilage of juveniles, especially in the growth zone and in adults only in the region of a healing fracture in a callus, a phosphates has been demonstrated (Robinson) which, like the renal phosphates, is able to liberate inorganic phosphates out of the serum organic phosphate compounds. The appearance of the activation of phosphates also makes possible a deposition of complex calcium salts into the cartilage basic substance and further explains the enrichment of phosphate in prepared bone in contrast to the usual relation of carbonate to phosphates in the serum.
Leeser, a Consultant Physician at the Stuttgart Homeopathic Hospital and a member of the German Central Society of Homeopathic Physicians, fled Germany in 1933 after being expelled by the German Medical Association. In England Otto Leeser joined the staff of the Royal London Homeopathic Hospital. He returned to Germany in the 1950s to run the Robert Bosch Homeopathic Hospital in Stuttgart, but died shortly after.
Otto Leeser wrote Textbook of Homeopathic Materia Medica, Leesers Lehrbuch der Homöopathie, Actionsand Medicinal use of Snake Venoms, Solanaceae, The Contribution of Homeopathy to the Development of Medicine, Homeopathy and chemotherapy, and many articles submitted to The British Homeopathic Journal,