The symptoms of iron on the digestive canal are best known as untoward actions in the usual treatment of chlorosis and also from the so-called Stahl baths. Thereby it is not sharply separated as to what belongs to the chlorosis and what to the iron, since the dyspeptic symptoms may be so similar: after eating many eructations of the food eaten or a taste as from rotten eggs; the food lies in the stomach for a long time and is rejected in the middle of the night; the appetite is very fickle and irregular, now ravenous hunger, now anorexia and there is an aversion to meat and particularly marked gastric pressure after eating meat; desire for stimulants such as brandy; pressure in the stomach after all foods. After the oral administrations of larger doses, the stools are green-black and there is constipation; after injection of iron preparations into the circulation diarrhoea may occur. The exact proving has brought out a type of vegetative diarrhoea: watery or undigested painless stools, soon after or during eating or at night. (These stools, called “lienteric” by the older physicians, are similar to those reported for china which is related in other respects as well). The colic and tenesmus and the hard dry stools from the Loffler proving are much less characteristic indications.
On the contrary deserving of greater esteem from this proving is the old observation of irritation in the urethra up to the neck
of the bladder with frequent tormenting urge to urinate. Associated with the Hahnemannian symptom: “involuntary urination, preferably during the day” one comes to the use of iron preparations (for example ferrum phosphoricum) in irritative states of the neck of the bladder in anemic women, particularly during pregnancy, in whom small amounts of urine are voided involuntarily on walking, but not on sitting or lying. The use of ferrum picrinicum in prostatic hypertrophy is to be ascribed to the picric acid fraction.
Finally there is a trend of iron action which should not be neglected even though its comprehension in the total picture still offers great difficulties: the rheumatic, neuralgic. Here especially are the sticking and tearing pains in the shoulder girdle, apparently in ferrum aceticum more in the right, in ferrum metallicum more in the left. They impair the movements of the arm. They are often ascribed to insufficient clothing or deficient covers, and are relieved by external warmth. A similar tearing-sticking pain also goes from the hip joint into the leg,” the hip is painful as if bruised, on touching, the patient cannot come on account of the pain which prevents walking; it is worse in the evening after lying down, he must arise and move about in order to lessen the pain up to midnight”; thus the description of Hahnemann reads. Cramps in the calves appear, worse at rest and at night. The extremities can hardly be kept at rest and during rest there is the necessity of moving them. This symptom awakens an impression of local stasis in the large muscles, which may be considered less as of of arthritic origin than of defective distribution of the blood and depression of the circulation and the metabolic exchange in the muscle apparatus, thought it is assigned to the large joints.
The nocturnal aggravation can be indicative. For the neuralgia in the teeth, relieved by cold water, worse at night, one finds no suggestion in the provings, but they are frequently observed in the untoward actions of iron.
Empirically iron is recommended in the cachexia of quinine and malaria.
The drug picture of iron must hold in essentials, at least for the present, for ferrum metallicum as well as ferrum aceticum, since the available provings do not permit a separation. Moreover at present no separation can be made for the oxide of iron or ferrous carbonate. Practically the simplest agent, the potentized metal, will always be preferred unless there is a special indication for a definite compound.
As ferrum phosphoricum today one uses ferric phosphate, Fe (PO4). Whether ferrous phosphate, Fe (HPO4), was present in the proving of Morgan, it is difficult to say.
When Schussler included ferrum phosphor. In his therapy in 1874, he did not actually include it on the basis of provings with this substance but on the idea, based on nothing, that iron was present in the organism and particularly in the muscle tissues, in this compound as a building and functional agent. He took over that which was known in homoeopathy of the action of iron, for his remedy, naturally as always with him under extremely simple, unprovable theoretic conceptions. Many symptoms of iron seemed to signify hyperemia to him. Since there were dependent upon the tension of the vessels and ferrum phosphoricum was a constituent of the musculature, also of the vessel musculature, thus he explained this substance as the functional agent for tension of the vessel; in great doses it can relax the tension of the vessel and therefore create hyperemia, in small doses on the other hand the relaxed muscle fibres are returned to normal tension.
INFLAMMATION AND FEVER
In spite of the untenable nature of this conception, the fact remains that ferrum phosphoricum more than the other iron preparations, has practically proven itself as a remedy for inflammation and fever. It has already been stressed that through iron not only “febrile states” but even fever may be produced in sensitive persons, moreover that Rademacher often used iron in the febrile diseases. In the proving with ferrum phosphoricum in the D 2, heat and dryness of the face and the palms of the hands, later of the neck and upper chest is noted. (Provings with ferrum iodatum have yielded febrile symptoms more distinctly). Schussler took ferrum phosphoricum into consideration in all the states which belong to belladonna in the homoeopathic domain. In the first stage of febrile diseases ferrum phosphoricum is used much more in homoeopathy on the basis of experience than on observations from the provings when the sensitive, anemic, easily exhausted ferrum type which tends to have congestion is present; when chilling or rheumatic causes are present. The nocturnal aggravation and the sensitivity to contact and alarm are general ferrum indications but do not differentiate from belladonna. The reported aggravation worse from movement, which stands in opposition to the other improvement through prolonged motion, concerns the rheumatic symptoms. The shoulder region is again the preferred site; the right side seems to be more markedly involved. But quite generally ferrum phosphoricum has frequently proven itself in acute as well as subacute febrile joint rheumatism. The improvement from cold applications refers to the congestive headache in any case not to the rheumatic pains, because in the provings it was expressly stated that these were improved by warm applications and covers. The fever following chilliness from respiratory passage involvement can increase up to the first stage of a pneumonia and here the tendency to bleeding is of value as an indication of ferrum: expectoration of almost pure blood. Moreover ferrum phosphoricum is particularly advocated in acute otitis in the first stage which it develops from a catarrh of the Eustachian tube, either as the first remedy or when belladonna fails.
Finally the already mentioned weakness of the sphincter vesicae in anemia with involuntary urination on walking is an indication, more of ferrum phosphoricum than for other iron preparations.
There is a special proving of ferro-iodide, FeI22. However, it is not frequently used, though it is best in those cases in which one desires an iodine action in a ferrum type, for example, in goiter. The proving with the pure substance and up to the 3rd trituration also has many iodine symptoms from the mucous membranes of the upper respiratory system, moreover irritative states of the urinary passages and the rectum; moreover there is the already mentioned fever (pulse increase and febrile sensation, without actual temperature measurements). In scrofulous and tuberculous affections with fever a combination of the two remedies so erethistic-consumptive as iron and iodine are, in any case, ought to be done with caution.
Ferrum muriaticum up to the present has not been subjected to a special proving. Today usually ferric chloride, Fe Cl3, is understood by it. It is indicated like ferrum aceticum in pains in the right shoulder. H. Schulz considers the chloride as especially suitable for bleeding and it has also been employed externally as a styptic.
Ferrum sulfuricum, FeSO4, has a purely empirical recommendation in Basedow’s disease with anemia as well as the other ferrum characteristics. The painless watery diarrhoea also seems to belong to these.
Ferrum arsenicosum, ferriarsenite, is not proven. It is used as an arsenic preparation in the same sense as chininum arsenicosum: in anemic, weak children without appetite, in splenic and liver enlargement, severe blood diseases, malarial cachexia, occasionally also in nephritis.
There is a brief proving with the D 6 potency but it is scarcely used. The recommendation in spermatorrhoea in weak anemic people with depression is purely clinical. The sole prover reported a feeling of numbness in the scalp, pressure and heaviness in the head and eyes, dryness in the nose and mouth, improved by the onset of sneezing, diarrhoea with bloody mucus and tenesmus and feeling of intestinal prolapse; more-over sticky mucoid, excoriating leucorrhoea and an unpleasant sensation of heaviness and sinking in the uterus. 597
Ferrum picrinicum is occasionally employed in states of exhaustion and difficulty in heating in which the picric acid fraction participates; more often in prostatic hypertrophy. The recommendation is purely clinical.
SUMMARY Constitution: ———— Oxygenoid: weak anemic persons with transparent skin in which widened veins appear, with congestions, but cold extremities, tendency to fever and bleeding, pseudo-plethora, tendency to tuberculosis and hyperesthesia (against noise), easily excitable and rapidly exhausted. Rapid growth.
Endocrine associations: Ovarian dysfunction (corpora lutea); thymus?
Chief Trends of Action:
1. Chlorosis and secondary anemia with irregular circulation, intermittent menstruation, or other irregularities of the menses (amenorrhoea but also too early and severe flow). Sterility, sensitivity of the os uteriexternum, anesthesia of the vagina.
Congestive headache and vertigo, nose bleed, febrile state, congestion to head, palpitation and oppression, hemoptysis.
2. Digestive disturbances.
Lienteric and nocturnal diarrhoea, nocturnal vomiting. Aversion to meat. Very variable appetite.
3. Urinary organs.
Frequent urge and impaired continence.
4. Rheumatic-neuralgiac complaints, especially in the deltoid.
Leading Symptoms: Worse at night and on sitting and lying, but again the need for lying: during and after eating; periodic.
China (in quinine cachexia as a curative agent). Special preparations, see above.
Usually the iron preparations are recommended in the D 6, though many cases of anemia seem to react only to material doses. Ferrum phosphoricum is often given in the D 12 as well as the D 6 and I have seen results from D 3 in the bladder weakness described.
Cobalt which is usually with its neighbors, iron and nickel, is less well known and used in its medicinal actions, and in school therapy, not at all. At most solutions of cobalt cyanide.
After the introduction of any cobalt salt the inflammation of the stomach is said to occur. Moreover Lewin reports nephritic alterations after the chronic subcutaneous introduction of cobalt.
The urine is said to be colored darkly by cobalt. Occasionally one finds spasms and central paralysis noted in cobalt poisoning in animals.
The Schneeberger bronchial cancer in workers in the cobalt industry in any case has no relation directly to cobalt but is probably to be ascribed to admixture of arsenic and even radium.
Cobalt was proven by Hering and Lippe (1850 and 1851) on the healthy. 598
Of the 314 symptoms reported there, only a few have been confirmed by clinical use, so that the sphere of action of cobalt is almost completely dark. Practice has not yet yielded any selection. The best acknowledge symptom is a pain in the back, in the lumbar and sacral region, which is worse on sitting, better on standing walking around and lying down; moreover weakness in the knees, trembling in the extremities, also pains in the legs on sitting. These symptoms are said to be associated with frequent seminal emissions and deficient erection and impotence has been reported.
Headache worse on bending over, accompanies the sexual-neurasthenic state, likewise the sleep is disturbed by virtue of sensual dreams. Toothache with the feeling as if the “teeth were too long” is also stressed and pains in the region of the liver and spleen (similar as with manganese), itching from the warmth of the bed, white coated tongue.
A summarized picture for clinical use which would be furnished by comparison with the related remedies, cannot be given at present.
The close kinship of nickel with iron and cobalt is revealed in the frequently repeated meaning and also approaches copper in a further (horizontal) relationship and is separated from it with difficulty in the earth.
In modern chemistry nickel sponge is employed (similarly as palladium) as a catalytic carrier of active hydrogen. From nickel vessels nickel is dissolved by plant, acids, vinegar, also lactic acid, in noticeable amounts on heating and cooking acid, in noticable amounts on heating and cooking acid containing foods. Therefore many foods become colored in nickel vessels, for example milk becomes bluish. These small amounts are considered as harmless because the intestine poorly absorbs nickel.
For the usual standards of toxicology this consideration of non- toxicity in any case is correct (as also with other metals which go into solution in slight amounts when foods are cooked, for example, aluminium). But whether the chronic introduction of such traces may not still be injurious, although they do not produce severe toxic symptoms and therefore are not easily recognized, is still not a determined fact. Naturally here also a special sensitivity of individuals comes into prominence.
Theoretic discussion in this respect and in this question of hygiene do not lead any farther and a nickelophobia is just as untenable as an aluminophobia. Only when such metal salts have produced injuries in special individuals and after removal of the presumed cause the disturbances again gradually diminish, would one be able to decide this question. For the validity of such a presumption naturally the better knowledge of the chronic action of such metal salts, as they are present or are strived for in homoeopathy must be obtained. With nickel this knowledge is still lacking as we shall now see.
The local corrosive action of the nickel salts scarcely enters our problem. Likewise the acute poisonings are not able to give us much help. That one can produce vomiting, diarrhoea and marasmus in dogs, with larger doses nausea and vertigo in man, contains nothing characteristic; nor does that smaller amounts given subcutaneously in man cause vomiting and in animals aid; outside of the intestinal symptoms, central nerve disturbances as trembling, twitching, stupor, paralysis are observed. In the chronic feeding of a nickel salts to dogs, outside of vomiting and diarrhoea, there is also lowering of body temperature, weakness and impaired cardiac work. Nickel is found enriched in the liver (analogous to Cu and Fe; the liver is probably an important site of storage of all heavy metals).
The nodular and vesicular eczema on the hands and forearms of workers who are concerned with nickel plating of objects is apparently not to be ascribed to nickel alone, but much more to the participation of alkalies in co-existing skin injuries. There is no doubt in regard to the local corrosive action, for example, of nickel sulphate.
A single proving of nickel arises from Nenning. Hering believed that the nickel was not free from cobalt 599 and states that it is exactly the extensive similarity of the results obtained by Nenning with nickel with his own with cobalt which speaks against the usually conceded doubtful merit of observations by Nenning. Nenning’s proving is found in Hartlaub and Trinks, Annalen de hom Heilkunst, Bd.3, p. 353.
With nickel the crude material of the results of proving are still too slight and the selection by practical use is still insufficient to delineate are periodically (14 days) recurring migraine which begins on the left (eventually passing over to the right, so severe that the patient cries out, worse 10-11 in the morning, diminishing to ward evening) (similarly as platinum which has the migraine more on the right); for nickel sulphate, the periodic neuralgia on a malarial basis also has a similarity with the iron indication for old malaria.
A survey over the symptom register of nickel, which is still insufficiently studied, permits even now a close connection to the effect picture of iron with the modification that in nickel, as is always true of non-physiologic metals the central nervous actions are more strongly stressed.
The erethism of the vascular system is characterized by symptoms as sensation of heat in the entire body, always more warm than cold sensation, great unrest and heat at night, heat, heaviness and fullness in the head (forehead) with vertigo, pressure on the vertex, as if from a hand or as from a nail, with improvement in the open air. The periodic 14-day headache is a precision from practical use. An asthenopia (eyes very weak, particularly evening, lachrymation on use) is brought into association with it and a peculiar symptom of macropsia: enlargement of remote objects (in contrast to the micropsia of platinum).
To these symptoms which all can ascribed to altered vessel tension are added the usual dyspeptic symptoms: nausea, pressure in the stomach, tendency to constipation or faeces evacuated only with great effort even though they are not hard, of diarrhoea after drinking milk. A special note is sounded by the symptom: gastric distress as from emptiness but still no appetite.
Various disturbances of the menses are reported: too late and too early and intermittent, thereby weak. They induce great weakness. Of the leucorrhoea it states, that it is watery and appears especially after urination.
The throat symptoms recall to some extent those of manganese: huskiness and a dry cough from tickling in the throat, roughness in the throat which is relieved by coughing. The throat pains are said to be characterized by the fact that the involved side is very sensitive to touch. A severe cough may necessitate sitting up and holding the head with the hands.
All these symptoms offer an uncertain selection for therapeutic attempts in the future. The characterization of Hering that the drug is useful for mental workers with periodic headaches who are also weak, asthenopic, who have a weak digestion, who are constipated, who find themselves worse in the morning on awakening, can only be suggestive.
OSMIUM According to the available insufficient reports osmium seems to have an entirely different action sphere than the other platinum earths with which it appears in common in nature. This is perhaps to be traced to the fact that the symptoms described particularly on the respiratory passage, skin and eyes are not of the metal, but erroneously from the so-called osmic acid, OsO4. In a finely divided state, osmium oxidizes rapidly in the air to this step. The symptoms of osmium oxide are mixed with those of the metals in homoeopathic literature, for the metal never occurs without the oxide.
Even at ordinary temperature osmium oxide is volatile and develops severe penetrating odoriferous, dangerously irritating vapors. According to Lewin the conjunctive and air passages are especially severely inflamed up to an asthmatic state and dyspnoea: but also bloody diarrhoea and a squamous skin eruption appears. After several months’ occupation with osmium there were headaches, sleeplessness, nausea, albuminuria, dyspnoea, attacks of chilliness and finally inflammation of the lungs. In the now discarded injection of osmic acid salts into tumors or nerves in neuralgia, an inflammation of the skin occurs which may progress to gangrene.
These studies arise on the basis of special tissue affinities which have developed from microchemical staining methods (fat with osmic acid-containing Flemming’s solution and nerve demonstration) and are known to the physician.
In homoeopathic literature there is a translation of a long experimental work with osmic acid on animals and men be Branell 600 from the Latin by Bojanus who added two short proving on himself and also mentions a proving by Stockes. 601
From these studies the homoeopathic osmium picture is abstracted. In actuality they refer not to the metal but to the volatile oxide, because the osmium triturations in the studies of Stockes certainly represent the oxide.
The severe inflammation on the conjunctiva, nose, larynx, air passages and bronchial mucous membranes, moreover the itching eczema and the odorous axillary sweat (resembling vinegar?) (the urine is said to smell like violets and the eructations like radishes!) are the local irritative manifestations which are less useful for homoeopathic indications.
The colour and light manifestations around objects and the cloudiness of the vision occasioned Norton to seek in osmium a remedy for glaucoma. Otherwise the frequent headache, especially bandlike, and falling out of hair are stressed. A characteristic useful picture of osmium is not available.
Our knowledge of iridium actions rests on so small a basis that practically we take no notice of it.
A single prover, Tafel, 602 gave a few symptoms, of which a numb sensation in the ears and also in other parts of the body and cramp-like contraction of the calves and in the middle of the sole of the foot, recalls a kinship with platinum. Otherwise Labouches 603 has made a number of clinical reports (anemia and states of weakness in rapidly growing children and old people) but it needs no further discussion at present.