In homoeopathy one hears in general that palladium is extremely similar to platinum in action. In general the association between the ovarian and mental symptoms perceived as the characteristic and the practically useful.
It is however possible that the older observations are to be ascribed to impurity of the preparation; because in nature palladium is usually found in association with platinum. However it is also probable that the close chemical relationship lies at the basis of the pharmacodynamic similarity.
From palladium by suitable preparation and use one may expect great actions; at least if one thinks of its strong catalytic properties. It is an acceptor for loosely bound hydrogen and through this can act oxidizing, but on the other side it may liberate a very active hydrogen and thereby act reducing. By virtue of this chemical property colloidal palladium is unknown and unused in school therapy.
The first drug proving with palladium was arranged by Hering 604 in 1850 on 12 provers. These are, apart from the provings with high potencies by McFarland (High Potency Provings) which are not available to me, the only ones which have become known. But in them there is nothing of a connection of palladium to the right ovary as good as nothing of the mental symptoms so that the clinical reports of Skinner and Lippe seem to be more valuable. Pain in the right ovarian region better from pressure, and a platinum – like but still somewhat different mental state, holds as the leading palladium symptom. This mental state is described as a great sensitiveness to praise, for applause and flattery and easily wounded pride; believe themselves easily rebuffed; in company easily irritated and excited, afterwards the ovarian pains are aggravated, the disposition depressed and tearful. The irritability is evident from the caustic expressions.
Of the many headaches are stressed: headache from one ear going through to the other over the vertex. Also a sensation as though the brain was shakened and a pressure sensation on the vertex is reported. More-over great lassitude, aversion for bodily labor, improvement of complaints after sleep is reported.
On the female sexual organs the sensation of sinking and downward pressure has given occasion for the use in uterine prolapse (as with platinum); pains in the right ovary with downward pressure, heavy sensation in the pelvis, frequent urination with swelling in the right ovary. The feeling of downward pressure is said to be relived by rubbing.
The frequent change of sensations among which is the sensation of numbness in the arms (similar as platinum), the aggravation by mental occupation, company, etc., makes the neurotic character of many symptoms plausible. To my knowledge there is no confirmation clinically for the above mentioned organic indications on the female sexual organs.
Platinum is never employed in its pure form in school medicine. It is considered as non-toxic and inactive. Platinum was formerly recommended against syphilis. It produces externally, irritation of the skin with the formation of fine vesicles which may become so sensitive that opening a flask of a platinum preparation (for example platinum oxide nitrate) produced an erysipelas like redness of the face with itching and heat in the skin. Platinum chloride (0.25:180.0) internally produces salivation, nausea, mild icterus, headache, increase in the urinary output, 605 in greater amounts also burning in the mouth, colicky pain, bloody stool;in rabbits and dogs paralysis of the extremities.
Such general toxic symptoms of platinum salts say little about the peculiarity of platinum action. In this respect we may presume from physico-chemical facts that platinum can become very active after proper preparation. In fine division the metal is extensively used for oxidation and reduction catalysis. Colloidal platinum acts as a ferment. 606 It effects a splitting of ethyl butyrate and also its synthesis from ethyl alcohol and butyrate acid and acts accelerates on the reaction like lipase. 607 It also accelerates the oxidation of alcohol to vinegar (like acetum bacteria) (Bredig). Platinum accelerates the decomposition of H2 O2 as catalase. The velocity of the catalytic effect of platinum is proportional to the surface of the metal. Dilutions which correspond to the D 8 prove distinctly active catalytically. The reaction accelerating catalytic action of platinum is depressed by extraordinary small quantities of HCN according to Loewenhart and Kastle 608 because HCN forms an insoluble coating on the metal particles. Through this the intermediate reactions necessary for catalysis are made impossible.
Provings on the healthy are found:
1. Gross and Stapf: Arch. f.d. hom. Heilkunst, Nd. 1, p.122,1822.
2. A brief imperfect proving of larger doses of platinum chloride and platinum sodium chloride. Hofer (Gaz. med. de Paris, Nr. 48, ref. in Allg. hom. ztg. Bd. 19, p. 374, 1840).
It may be due to the insufficient proving with various amounts or more probably in the type of the metal that functional actions on the side of the nervous system predominate and the sexual organs are stressed. The most characteristic is the strongly increased excitability of the nervous system with tendency to paroxysms. One will involuntarily recall the reaction accelerating action of colloidal platinum. In the tense state it comes to sudden reverses which give rise to an impression of hysteria. On the peripheral nerves neuralgias, paraesthesias and anesthesias come into evidence. Then a paralytic-like weariness follows. The abnormal increase of tenseness extends further to the female. Here according to all evidence a close reciprocal relation between the nervous-psychic state of tenseness and the female sexual organs is outstanding in platinum. Daily observations show the high grade dependence of the nervous equilibrium (disposition, neuralgias!) on the function of the female organs. The interrelationship through the endocrine organs is probable and in this form the old hypothesis of hysteria as a malady of the sexual organs could easily become restored.
The mental state of the platinum picture remarkably recalls that of hysteria; we find the suddenly varying disposition, from elation to depression, from laughing to crying; fear of demons, of losing the mind or of dying, worse in the evening, great influence of anger and fright. It seems noteworthy for the haughty nature of platinum that all persons and objects seem very small. It is to be considered that this smallness, this micropsia is functional and neurotic and not due to disturbance of accommodation or convergence. And indeed the association of superiority, of pride, a peculiarity so often found in the “hysterical” transformation will be found a flight from the feeling of inferiority. Platinum likewise is employed in the outspoken grandiose ideas of the manic state. Moreover common to the picture of platinum and hysteria is: the physical symptoms diminish when the mental symptoms appear and reverse.
The increase of irritability in platinum, as in hysteria may go on to paroxysms, to clonic-tonic spasms, to crying out, dyspnoea, etc., joined with characteristic sexual erethism which one finds expressed by preference in positions and attitudes taken. The increased erotic trend also comes to expression in dreams.
Platinum also has a series of sensations in the peripheral nerve fields which seem to stand in transition from the psychic neurotic to be peripheral nerves. The increase of nerve irritability increases and decreases gradually, the pains of platinum having this characteristic-like stannum. The pains frequently are followed by numb sensations, a sign of excess over a certain stimulus threshold. The peripheral nerve actions are said to go on to trophoneurotic effects on the fingers and toes and toes and platinum has even been recommended for caries of the bones of the feet. The platinum picture is rich in pains and they give an impression of hysteria. Sensations of tension and numbness prevail: sensation of numbness or superficial coldness appears in spots, constriction and numbness of the head and in the scalp as if tensed rigidly, similarly in the neck, worse evenings and on sitting; sensitivity from cold, numbness and crawling in the eyes, ears and in an entire half of the face as well as in the feet on sitting, also tensive cramp-like constrictive pains as from a firm band around the extremities. But this sensation of constriction also comes in the neck, in the epigastrium and in the chest where it embarrasses breathing, Another characteristic sensation is that of a plug, particularly in the headache, with painful pressure from within. The headache can be associated with trembling and twitching of the eyelids and flickering before the eyes; it is worse at rest and in the evening also in a warm room, better in the open air. The slow increase and decrease may also be suggestive here. Moreover the plug sensation is also noted in the chest and abdomen. A feeling of weakness prevails in the back, sacrum and the extremities and may become quite severe. Trembling or rigidity of the muscles may be present.
The organ actions of platinum in the first line involve the sexual erethism exists. The excessive sexual libido which is said to be present in the male is not so characteristic as for the female sexual functions; indeed in general platinum in its entire character is adapted for the female sex to a special degree. The excessive irritation of the sexual organs conditions the sensual itching of the genitals, at times associated with anxiety and cardiac palpitation: there is a tendency to onanism and the excitement may increase up to nymphomania. Thereby a painful sensitivity of the parts may be present, likewise vaginismus. The marked flow of blood to the parts is expressed in the pressing downward and the feeling as if the menses would appear. Platinum is also extolled in actual descent of the uterus. An irritated state of the ovary which is designated as ovarian neuralgia is often associated with a migraine in the frontal region. Corresponding to the marked excitation, the periods are too early and too profuse (not too long). The blood is said to be dark and clotted. Cramps occur at the appearance of the menses at times; during them there are many pressing pains. Less definite as a point of departure, theoretically as well as practically is the reported hardening of the uterus which has led to employment in myoma.
On the digestive organs there is an aversion to food because of sandess, then again ravenous hunger and rapid eating, loud eructations, persistent nausea with anxiety and trembling. Obviously all these stand decidedly under the influence of the psyche. Formication in the anus, a shuddering of the entire body after stool also reflects the nervous component. A constipation with unsuccessful urging or only insufficient evacuation is said to occur on traveling. One other symptom is peculiar that the stool though soft as clay, remains adherent to the rectum. In the constipation and colic of lead poisoning platinum is an antidote.
On the respiratory organs and the heart occur only nervous manifestations in platinum: loss of voice and brief dry cough which is depicted as “hysterical,” palpitation causing anxiety and an almost spasmodic yawning.
Dark, thin women and girls of tense fibre are said to be the types which are most sensitive to platinum.
Central and peripheral nervous system. Hysteria. Increased nervous irritability, paroxysms. Psychically marked changes in disposition, changes between physical and psychic symptoms. Haughty nature. Neuralgias, paraesthesia, tense, numb sensations. Feeling of a plug; slow increase and decrease of pains.
Great sensitivity of the female genitalia. Nymphomania. Ovarian neuralgia. Menses too early and too profuse. Downward pressure.
Under psychical influence: constipation on traveling. Stool rema- ins attached to the bowel though like softclay. (Rare: tropho- neurotic ulcers; lead colic.)
Worse on sitting and in the evening. Better in the open air. (Right side seems to be preferred.)
As a rule D 6 is employed.
Manganese chemically is a close neighbor to iron. Corresponding with this fact in nature manganese is usually found in association with iron. The relationship is “horizontal” as so frequently occurs in the periodic system.
In plants at times manganese seems to have the role of iron as an oxygen carrier and indeed in the test tube oxidation catalysis of manganese salts is often used. Small amounts of manganese enter the human organism in grains and plants but nothing is known of a physiologic vital role of manganese in the human organism.
It is stated 609 that manganese as iron causes the number of red blood cells and the hemoglobin to increase markedly, but a lessening in the after effect, although exact investigations on this point have not been performed. Nevertheless manganese compounds have often found use in chlorosis and secondary anemias (usually with iron) on account of this iron-like action.
In the compounds where manganese appears in the basic fraction (2 and 4 valent) as well as in the acid fraction where it is 6 and 7 valent manganese determines the action, so that there is a great pharmacologic similarity in all manganese compounds. The compounds most used are manganum aceticum, Mn (CH3 COO)2 which Hahnemann introduced into materia medica and potassium permanganate KMnO4. But also manganum muriaticum, MnCl2, manganum carbonicum, MnCO3, and the (4 valent) MnO2 employed in the same sense as the acetate.
The compound best known in medicine is the dark red crystalline potassium permanganate, which produces a violet red solution in water and even in a solution of 1:500,000 still gives a rose red color in water. On account of its marked power of oxidation potassium permanganate is often used as an antiseptic and deodorant. A further use occurs in morphine and phosphorus poisoning as well as an antidote in snake poisoning. A strong concentration acts locally on the mucous membranes producing marked swelling, dark discoloration and scab formation; particularly dangerous is the edema of the glottis. In poisoning there is vomiting, cyanosis, and finally cardiac paralysis. Often the difficulty in speaking is prominent. Albuminuria is also observed. On the contrary it has not been proven in manganese poisoning that manganese is excreted through the urine so that the kidney is not known to be a site excretion of the poison; though the intestine is with all heavy metals.
The experimental acute animal poisoning with compounds in which manganese makes the basic fraction as the sulphate, reveals some action on the central nervous system in the form of paralysis and tetanic spasms, so characteristic in chronic manganese poisoning. But also inflammatory alterations are found to the blood forming system.
It is particularly remarkable that chronic manganese poisoning has such a great similarity in its central nervous system symptoms to those of Parkinsonian syndromes and in a lesser grade to multiple sclerosis. The first description, on which apparently Lewin has based his report has not been forgotten in homoeopathic literature. In workers who were occupied in crushing manganese, Cowper 610 observed paralysis especially of the extremities with propulsion, moreover weakness of voice, vacant facial expression, flow of saliva especially on speaking. Even this first observer noted that though years elapsed after the removal from the work, practically no improvement occurred in the condition. Industrial manganese poisoning was described more exactly by V.Jaksch. 611
Outside of the spastic paralysis symptoms (without Babinski), a peculiar gait and walking on the metatarsal phalangeal joint, propulsion and retropulsion, the facial mask, flow of saliva, and monotonous speech, v. Jaksch described spontaneous laughing and crying and psychic alterations. Likewise nystagmus, trembling of the tongue and extremities and limitations of the visual field (according to Lewin) are observed, moreover writing in small letters without the ability to make them larger. These represent many signs of disease of the basal ganglia as we see them after encephalitis lethargica so that one would think manganese poisoning does not improve, then he will not place his hopes too high in the expectations of a possible therapy in spite of the similarity. All these symptoms show degeneration in the central nervous system whose slight power of restitution is well known.
The process which lies between the acute poisoning and the endstage of the chronic poisoning, is to be conceived in the proving on the healthy; from this intermediate domain we shall best gain the healing indications of the remedy.
The provings of manganese salts are found:
1. Hahnemann: Reine A.M.L., and 2 Aufl., Chron. Krankh. (of mang. acet. and mang. mur.).
2. Lembke: Neue Ztschr. f. hom. Klin., Bd. II, p. 28, and Bd. III p.4 (of mang. mur. and mang. oxid.).
3. H. C. Allen: Amer. Hom. Observer, Bd. III, p. 345 (of kal. permangan. with such great doses that almost only acute mucous membrane symptoms of the mouth were observed).
As a point of departure for the picture of manganese one may take its similarity with iron; but at the other end stands to some extent the nervous system actions which are very decisive in the nervous system actions which are very decisive in the heavy metals foreign to the body (as with almost all), but which we need not discuss from what has been said above. The similarity to iron is revealed: anemia, pale face, great fatigue and sensation of weakness, general improvement by lying (but especially as with ferrum and holding for the cough), congestion to the head, restless anxiety (also better from lying still), many headaches (as if too large and heavy) which become better in the fresh air if they have occurred inside a room and better in a room when they have occurred in the open air.
The disturbances of the menses belong here: the periods come too early and frequent, but are weak; likewise intermenstrual bleeding occurs. But amenorrhoea is also reported from kali permanganatum, moreover marked pains at the period, in spite of the fact that the remedy has not been proven on healthy women. But Stauffer considers it as proven in the dysmenorrhoea of the anemic. Both forms of menstrual disturbances are found in iron. Also the accompanying digestive disturbances are similar to iron, but without special significance in manganese. Pressure burning and sensation of heat in the stomach and in the abdomen and especially in the hypochondria, acrid eructations and nausea are the signs. The relief of the abdominal pains by pressure is occasionally mentioned in the provings and by Lembke; there is also aggravation of the pressure in the stomach from external pressure.
Likewise the trend toward the liver and the spleen is to be recalled as they show patchy inflammations in acute poisoning. Lewin mentions icterus in acute poisoning. A clinical proof for the hepatic and splenic maladies as well as in the hemopoietic system is not available at present.
Also the tendency to persistent catarrhs in chlorosis with the tendency to transition into tuberculosis is again found in manganese. The symptoms in the upper air passages are expressed even more distinctly with manganese than with iron. Common with iron here is the characteristic modality that the cough is better on lying down. Dryness, roughness and constrictive sensation in the larynx, a deep cough without expectoration, on the other hand, easy expectoration in the morning without much coughing, expectoration of small yellow green clumps of mucous or bloody sputum; the catarrh is described in this way and the tendency to tuberculosis is very distinct. These catarrhs are aggravated when the weather becomes damp and cold. The severe mucous membrane alterations in the throat with oedema and ulceration in the local action of kali permangan have given occasion for the use of this remedy in diphtheria.
Besides the catarrhal symptoms which involve the throat and larynx, there is still another trend of action on the larynx, in manganese, that of innervation of the vocal cords. The weak and monotonous voice of chronic poisoning has been mentioned. Therefore the use of manganese is worthy of note not only for the catarrhal huskiness in professional speakers but also for the voice disturbances conditioned more by nervous factors. The lary- nx also seems to be a site of elective action for manganese and disturbances here, from nervous to tuberculous, come in the therapeutic field of manganese.
SENSE ORGANS AND NERVOUS SYSTEM
The frequently observed symptoms in the ear, sensation of occlusion and difficulty in heating, ear noises, pains which radiate from other parts of the body, especially from the throat on speaking and swallowing, obviously stand in association with the catarrhal symptoms and are mediated through the eustachian tube. The changes in the weather are of great influence here.
Pains also go from the teeth into the ears; the toothache becomes unbearable on contact with cold. Asthenopic complaints appear as signs of nervous exhaustion from singly directed efforts: the eyes pain from near work and from looking into a bright light.
A great sensitivity of the skin sensory organs is expressed in the symptom: pains in the most diverse parts of the body on touch as if they were sore.
All these nervous symptoms then pass over into many types of neu- ralgias of various parts of the body from altered sensation and numbness to twitching, tension, stiffness, weakness and trembling in the muscles and tendons, especially in the legs which obviously introduce the central disturbances of motion as early irritative symptoms to the central spastic paralytic manifestations of chronic manganese poisoning. The region of the knuckles and heels is an especially frequent site for the appearance of the pressing site.
Added to the above trends of the iron-like picture of the blood injuries and the special tendency in manganese to definite involvement of the central nervous system are certain single assertions in the symptom registers which lie entirely outside of the sketch up to the present. These are the swellings over the tibia apparently inflammatory, sensitive to touch, which have been viewed as periostitis and erythema nodosa and swelling and pains in the joints with transversely changeable sites. Manganese has no other indications for the bone and joint inflammations. Itching and burning of the skin, unhealthiness and tendency to suppuration have also been cited as indications in old eczema and psoriasis but without any clinical confirmation giving the right for this.