POISONING
With such extensive and common actions after absorption of lead at first it seems remarkable that so few experiences on its healing properties have been gained and retained. But it is comprehensible when one reflects how great a role the time factor has played in the appearance of the effects of the absorption of lead. Acute poisonings in lead are of slight significance. They require large amounts and then show almost only gastro-intestinal symptoms: salivation, bad taste, nausea, vomiting of masses of mucous, gastric cramps, and finally collapse with cold sweat, often Cheyne-Stokes breathing and convulsions.
However lead poisoning so thoroughly important practically requires very frequent, small, finely divided amounts of lead and a long time for its development. Poisoning may long remain latent and then come into evidence when the external occasion has long since disappeared. Also the very slow excretion of metal which is moved with difficulty from the body, is even slower than the intake, scarcely furnishes an explanation for the situation. The accumulation purely to the amounts up to toxic doses according to all evidence does not correspond to the actual situation. According to animal experiments it involves less 688 a retention and accumulation of the toxic substance and much more a summation of slightly damaging after-effects. Also the frequent repetition of minimal insults by the smallest amounts of lead, but over a long period, leads finally to demonstrable organ injuries. The comparison with the constant dropping which wears away the stone, not through force but the frequent recurrence, seems especially likely. It symbolizes only one mechanism which we utilize so well in provings on the healthy and also advantageously many times in the therapeutic dosage. That the effect with such a procedure also is entirely different than with a single massive dose is emphasized with particular clarity in the example of lead poisoning. Because never in acute animal and human attempts with inorganic lead were similar acute pictures of lead intoxication obtained as those which are known from chronic intoxication. Particularly the late results in the nervous system appear exclusively in the chronic poisoning. With organic lead compounds (triethyl lead) however one can also experimentally produce nerve symptoms. This suggests that the nerve affinity of the chronic acting inorganic lead occur through a gradual transformation into an organic (lipoid soluble) compound. This behavior in lead is entirely similar to that in mercury.
Chronic lead poisoning seems at first to fulfill all the requirements which one can expect from a drug proving to and to make unnecessary intentionally arranged investigations in view of the large amount of observation material. But the descriptions of poisoning usually begin with symptoms which already represent the existence of definite organ injuries. These organ involvements are very good therapeutic signposts but the initial symptoms in sensitive people are (as expressions of the active defense) still more valuable for this. And this gap must be filled in as far as possible by intentional investigation in man. Lead obviously offers special difficulties, because its harmful effects remain latent for a long time and then suddenly manifest them-selves. Even if the available provings on the healthy 689 supplement and make a little precise, still a disproportion remains between the repeatedly demonstrated and extensive organ damages produced by lead and the present utility of these apparently so significant indications. But up to the present the significance lies more in the pathologic anatomic alterations than in the observation of subjective details and the very important modalities. Nevertheless that is what can be utilized homoeotherapeutically in the available observation material and usage indicates that this is considerable in comparison to the otherwise complete neglect of lead as an internal remedy.
Since the great trend of the lead picture can be designated distinctly as a chronic poisoning, we can use it as a guide and need only to discuss the therapeutic evaluation and to add the available details where they are known.
PLUMBUM METALLICUM
It is certain that lead is a chronic remedy of persistent, often only late action. Its suitability for chronic diseases is not excluded by the fact that it can produce sudden improvements.
The earliest objective signs involve the blood. The basophilic stippling of the red blood cells early shows an injury to the red cells which subsequently can lead to anemia and a wan, yellow grey, subicteric lead pallor; moreover an outspoken icterus can occur. The hemolytic action is obvious. Hematoporphyrinuria can be considered as a further sign of blood destruction by lead (with pathologic formation of this pigment in the liver). In this respect liver damage from the plumbum absorbed (in Kupfer’s star cells and the capillary endothelium) is probable. Lassitude, decrease of appetite, emaciation, wrinkled wan skin complete the cachectic picture. But the pale yellow appearance also depends partly on the vasoconstrictive action of lead.
Even in the early stage constipation with abdominal pains up to colic is present. The well known lead line, a precipitate of lead sulphide has merely diagnostic significance. Psychic disturbances likewise appear early: slowed comprehension and failure of memory, “cannot find the right word,” depression and anxiety (fear of being murdered). The state resembles that of cerebral sclerosis. Also in the later stages, after cerebral hemorrhage with hemiplegia has occurred, plumbum belongs to the remedies which deserve some confidence, for one finds many parallels with the symptoms of lead poisoning, especially in the sequela of central paralysis. The later symptoms of severe brain injury, the picture of so-called encephalopathia saturnina with mania, delirium, hallucinations, and illusions, eclamptic and epileptiform attacks, coma, give the parallel to general paresis, delirium tremens, epileptic insanity, etc., but are no longer useful therapeutically.
CHIEF TRENDS
In manifest lead poisoning two chief trends of action can be differentiated: on the blood vessels and the nervous system. But the two systems are intermingled so that it is often difficult to determine the initial point of the toxic action. A majority of the symptoms can be traced back to vascular actions. They vary from angiospasm and ischemia to severe injuries of the vessel intima, endarteritis, and sclerosis. The increase of blood pressure is also conditioned by extensive vessel spasm.
VESSELS
Even more frequently than the already mentioned cerebral vascular action is the injury to the kidney by lead; as the result of the ischemia there is a chronic nephritis with degeneration of the parenchyma or a nephrosclerosis in consequence to an endarteritis. If other etiological causes have induced these two morbid states, which merge into each other, then the prolonged
use of lead which acts very similarly is recommended in the middle or high potencies, in order to save what may be saved.
SMOOTH MUSCULATURE
Even in the spastic contracture of the intestine which is designated as lead colic, one can be in doubt whether it is to be traced more to the spasm of the mesenteric vessels or to direct excitation of the smooth muscle through the vagus. This syndrome also gives frequent therapeutic indications for lead in the event of colic and constipation. The attacks are spasmodic, radiating, mostly below the umbilicus, with rigid retraction of the abdominal muscles; they are relieved by pressure so that the patient bends double at one time but at another he has the desire to stretch. The “thready pulse” during the attack shows the marked participation of the vessels. Persistent spasic constipation can also appear with or before the colic and may be an indication for lead by itself. The anus is spastically contracted and retracted, if stools are passed they consist of hard, black balls. There is a spasmodic urgency to stools, but even flatus is retained. The intestinal paresis can produce severe signs of intestinal obstruction, of intussusception, still one would not pursue medical therapy in such parallel states but seek to relieve the mechanical cause. But if it involves a dyspraxia intestinalis arteriosclerotica, this true image of lead action, then plumbum is to be esteemed as a remedy with better prospects of success.
Oesophageal and gastric spasms are more rare than the intestinal. The picture resembles the tabetic crisis and the similarity with tabes extends in many other directions as we shall see (arthralgias, nerve actions).
The crampy pains with retraction of the abdomen can also direct attention to plumbum in dysmenorrhoea. Thereby the bleeding may be immoderately severe or amenorrhoea may exist. The tendency to abortion in lead poisoning is very great, even in wives whose husbands have lead poisoning. How far the degenerative alterations in the reproductive glands and the parotitis, the trophic actions, originates in the vessels or immediately through vegetative nerves, must be left undecided. Impotence, testicular swelling and atrophy can scarcely be therapeutic indications for lead. Irritative phenomena in the external genitals as cremasteric spasm, sensation of constriction in the testes or hyperesthesia and spasm of the vagina (vaginismus) are more inviting for therapy, even though there is rarely opportunity for it.
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,