CATALYTIC WORKING MECHANISM
It is now a question as to how the action of metal hydrosols and collargol is to be understood in septic diseases in particular. The simplest conception is that the infection producers are directly attacked through the finely divided metal. The killing of protozoa (paramecia) according to the studies of Filippi is effected even in a dilution of colloidal silver of 1:450,000 (also at least the D 5). With the various bacteria dilutions of 1:50,000-1:100,000 (also D 4-D 5) still effect complete depression of development, in case the colloidal preparation was sufficiently fine. Against molds colloidal silver is fairly indifferent. With the usual doses of collargol with intravenous injection (011-0.45 g.) the dilution in the blood corresponds to the amount effective in the test tube (about D 4).
But we know the finer process in the death or the depression of development of the microorganisms just as little in the test tube as in the organism. However there are single points of departure for the view that the influence of finely divided heavy metal on micro-organisms is concerned with a catalytic process, that is a promotion of the defense reaction of the organism against the actions of bacteria purely by the presence of the metal. Schade 637 assumes such an action to be an acceleration of oxidation. Nearly all toxins are exteremely sensitive to oxidation. And it is exactly the heavy metals which are suitable catalysors, which can accelerate oxidation in a great circle of reactions, (group catalysors). It is to be observed that this catalytic action is not limited to colloidal silver nor to definite reactions. The inorganic ferments (according to Bredig) in general are not limited to single reactions as are the organic ferments. “Now catalysis is a function of the (silver) surface, therefore proportional to the grade of division of the silver. The finer the particles, the more intensive the capacity for catalysis” (Schade). The dispersed red solutions are more effective than the green and these again are more active than the crude grey.
In regard to the action on toxins Hamburger has shown the depression of staphylolysin by collargol as measured by its hemolytic action. 638 Fod and Agazotti 639 could not demonstrate an action of silver hydrosol on toxin in the test tube, but when it is injected immediately after the toxin into the blood stream: an intravenous injection of collargol then defends animals against tetanus, diphtheria, and dysentery toxins in doses which are greater than 10 times the minimal lethal doses. The authors therefore conclude that the silver hydrosol activates the oxidizing ferments of the organism.
The salts are lethal on protozoa in about the same dilution and the metal content as the colloid of the same metal. But according to investigations it seems that the influence of the colloidal metal is less on the ferments than that of the salts. It is worthy of note that small amounts of silver hydrosol activates the diastatic ferment of the liver and of the blood serum. The acceleration of autolysis, that is, the self digestion of an organ through its own enzymes, has been demonstrated with all hydrosols investigated and silver belongs to the hydrosols which promote the autolysis in minimal amounts. While normally the uric acid arising in autolysis is subjected to further destruction through a uricolytic ferment, this action will be depressed by silver hydrosol.Silver hydrosol action on autolysis can be poisoned by minimal traces of HCN and likewise in its capacity to destroy hydrogen peroxide. 640 This is also a type of catalysis and it is a support for the conception that the action or bacteria is catalytic. And what may be presumed on single micro- organisms is an acceleration of the process of oxidation which has been confirmed by the metabolism of the total organism. According to Ascoli and Izar 641 silver hydrosol, which however must be stabilized with gelatin, increases nitrogen metabolism and indeed chiefly the nuclein metabolism in that a significant increase in uric acid occurs in the urine. The stabilized silver hydrosol thereby contains amounts of silver salts which qualitatively exert analogous actions. Thus it is understandable that at the end of a very long maintained introduction of silver emaciation and cachexia can develop, as also with other chronic metal poisonings.
All these actions on microorganisms and bacterio-toxins, on normal ferments and enzymes of autolysis and on nitrogen metabolism are not peculiar to silver. Special effectiveness of silver in infectious diseases is entirely missed in our drug picture. It is not concerned with a reaction on the organism which is specially limited to silver, but here expresses only a group affinity. And even in these non-specific actions there are quantitative relationships so that one can refer to the catalytic effectiveness of smallest amounts. How slight indeed the concentration may be in biologic actions is evident precisely with silver! Walbum 642 has seen actions of silver nitrate in artificial tar tumors of mice in concentrations which correspond to D 23.
ARGENTUM METALLICUM AND ARGENTUM NITRICUM
If we would learn the effect field of silver, whether as the metal, or as the nitrate, we must place our trust in the results of provings on the healthy. With silver we have outside of the original provings of Hahnemann 643 on 9 provers and an extensive reproving by the Austrian proves and indeed by I.O. Muller of argentum nitricum with 7 proves (and females as well) 644 and a self investigation of Huber with Argentum met. 645 In the extensive work of Muller one finds the entire history of silver and its use discussed in detail. A further proving of argentum metallicum is found in Hering. 646
The action on the nervous system stands out as the chief trend of silver in the organism and indeed especially on the central; the silver maladies have a slowly progressing deep penetrating character. The tendency to involve the nervous system seems (according to I.O. Muller) to have first been recognized by Paracelsus as his “virtus cephalica.” A series of psychic and mental symptoms appear in the provings in which argentum metallicum affects the intellect alone; in argentum nitricum it is especially the behavior which is involved. In both there is blunting of thought, weakness of memory and loss of it. All mental and head symptoms are aggravated by mental effort. In argentum nitricum it is expressed especially as a general trembling weakness with anxiety and mental restlessness, anxiety as if something terrible was to happen, or that death would occur or some planned undertaking would go amiss. Likewise hastiness is striking, tendency to impulsive acts, for example to thrust the feet through the window. Hahnemann states: anxiety which makes him move rapidly. Time goes much too slowly for the argentum nitricum patient (as with cannabis indica). There is great desire to arrive at the right time; through this diarrhoea can be provoked. With the great weakness there is great bodily unrest and nervous excitation, in isolated instances convulsions at short intervals. The nervous exhaustion is expressed in other cases in a propensity for sleep. In the anxiety there is another accompanying symptom, the tympany which embarrasses the breathing of the patient. An important symptom for argentum in general is vertigo and lack of recollection, “a kind of intoxication,” according to Hahnemann; in one case “semi-sleep with vertigo with a kind of convulsive shaking of the body as in epilepsy” occurred. This type of vertigo has become the homoeopathic indication for the use of silver in epilepsy, for the so called epileptic vertigo or for epilepsy with much vertigo, particularly at night. Hahnemann did not consider the empiric fame of argentum in the usual type of epilepsy as plausible and asserted that the cures could be traced back to the copper content. In actuality copper was much more frequently employed in epilepsy than silver. Moreover amongst the severe manifestations of poisoning with silver nitrate a case is described in which the attacks closely resembled epilepsy: “complete loss of consciousness with absolute loss of sensation, convulsive movements of the upper extremities, face and trismus; eyeballs fixed and directed to wards above; pupils widened and insensitive (against light?). Later deep coma with loss of sensitivity which lasted two hours and for two days recurred paroxysmally.” 647 In a case of epilepsy with the other symptoms referring closely to argentum nitricum there was no doubt in my mind of a healing action. Transient blindness is also observed in the vertigo of argentum. Together with the peripheral nerve manifestations and the vertigo we perceive the indication for the use of locomotor ataxia or beginning tabes dorsalis. In particular uncertain standing and walking, also in the dark and after severe mental effort is cited.
Headaches are practically never absent in silver provings; they are severe, boring, pulsating and an especially frequent site is the left eminentia frontalis, for example, in Muller’s proving. This preference for the left side in argentum nitricum has also been demonstrated in other respects: the left side should be strikingly weak. At the height of an attack of hemicrania there may be vomiting of bile and in general the entire organism is involved so that the patient feels miserable and weak. At times the attacks of pains have an out-spoken 24 hour periodicity, 11- 12 in the morning being cited as the aggravation time for argent- um nitricum show a nocturnal or early morning aggravation. A feeling of enlargement of the head is reported many times in the provings so that the entire head feels puffy and distended. This feeling as though a part of the body was distended, is generally considered as more characteristic for argentum nitricum; it recurs in the tympanitic abdomen and the sensation of enlargement with pain in the ovarian region. The headache is relieved
by pressure and firm bandaging, particularly when the sensation of enlargement is present. Cold is also said to relieve. Overuse of the eyes, particularly from close work is also said to aggravate.
A series of complaints appear in the peripheral nerves. Dental pains are aggravated by contact with cold water. Drawing pains in the left infraorbital region, in the lower jaw and the teeth are mentioned many times so that argentum nitricum comes into considerations for facial neuralgia. Neuralgic pains are observed especially frequently in the sternum and the ribs, in the region of the sternal junction of the fifth left rib and along the entire border of the left lower ribs. These pains are aggravated by contact. Severe, cutting, drawing, lancinating pains go through to the back, along to the sacrum and shoot like lightning through the arms and legs. Crawling as if insects were on the skin; sticking and biting in the skin, feeling of part going to sleep, complete the picture from the sensory side; the tendency to trembling and convulsions, the heaviness, fatigue and stiffness especially in the calves from the motor side. It has already been stated that the peripheral symptoms have led to use in diseases of the spinal cord, in particular tabes, but they may offer still other signs for silver.
Newer reports, Particularly from the American side, that argentum metallicum has special association to the joints, bones and cartilages appear to go back to Heber’s self-investigation. But when one reads through the symptoms of the proving, then there is no occasion for such a conception as it is brought to expression ion Huber’s summary of his work. Even if in his report, pains as if dislocated and bruised, recur very frequently and often about the region of the joints, still these symptoms speak for the peripheral neuralgias and a participation of the bones, cartilages and joints is in no way made probable. By American and French authors (Boericke, Jousset) a contraction of the finger and partial paralysis of the forearm is cited for argentum metallicum and taken as indications for writer’s cramp. Of the peripheral sensations tickling and itching as from the crawling of insects on the most diverse parts of the skin is most frequent, also in the anus, and at times itch-like stippling. This nervous itching has occasion Sellention to employ argentum in pruritus.
MUCOUS MEMBRANE AND ORGAN ACTIONS
A splinter-like sensation is characteristic for argentum nitricum on the mucous membranes, particularly the throat and the urethra is stressed. This stimulds goes farther, in the mouth and throat to general dryness with a feeling of soreness and roughness, particularly in the larynx, with much hawking in consequence to tenacious, thick mucus, up to hoarseness which is increased by use of the voice. Argentum metallicum is gladly used by singers and speakers when they have an aphonia after prolonged use of the voice. Also a dry cough which arises from laughing or tickling in the larynx or from a raw spot in the suprasternal notch, with considerable sputum is repeatedly mentioned. In argentum metallicum it is said to have the appearance of boiled starch. It approximates a severe intoxication when symptoms appear from the deeper respiratory organs: dyspnoea with a sensation of suffocation and desire for fresh air, worse in the horizontal position and better on moving about. We know that the respiratory symptoms in poisoning in animals take on a spasmodic picture up to paralysis of the diaphragm and respiratory standstill through paralysis of the diaphragm and respiratory standstill through paralysis of the respiratory center. The dyspnoea dependent upon meteorism in argentum is also to be recalled. Moreover a sensation of weakness is noted particularly in the left chest. If we put the symptoms from the respiratory organs together then the impression is increased that it is a nervous disturbance for which argentum is primarily adapted and that no sufficient support is present for the reports of laryngeal or pulmonary tuberculosis. The form of asthma and whooping cough coming under consideration also and indeed more often succumbs to the influence of the related copper. Great desire for fresh air and improvement on moving around are cited as indications.
The slight influence of silver on the heart, nocturnal palpitation without particular alteration of the cardiac action does not awaken much confidence in the old indication of angina pectoris. Palpitation and unrest in the cardiac region are obviously of a functional type; they are said to be aggravated by lying on the right side and improved by lying on the left side (counter pressure).
Marked inflammatory manifestations in the mouth, as burning, sore tongue, white coated tongue with swelling of the papilla, ulcers at the border of the tongue and margins of the cheeks, swelling, looseness and easy bleeding of the gums, inflammatory swelling of the soft palate and increased flow of saliva belong to the rarer manifestations. Together with the still to be mentioned emaciation they have been cited as indications in mercurial cach- exia. Of the further tendency to ulcerations in the throat, those of luetic origin should be particularly mentioned but this indication is extremely rarely employed.
The gastric complaints of argentum nitricum consist in severe gastralgias; a small spot between the navel and the xiphoid is very sensitive to pressure or in the stomach immediately under the short ribs there is a sticking pain like ulcer; attacks of gastric pain appear particularly towards midnight with nausea and tendency to vomiting which often increases up to gastric spasm, radiates in all directions, but particularly towards the chest impeding respiration and it is said to be relieved by pressure. Anorexia as well as ravenous hunger may occur. Likewise school therapy has employed argentum nitricum in gastralgia and in gastric ulcer but in massive doses and under the conception of an astringent action. It is not improbable that the results even in this therapy may depend upon the minimal fractions of silver succeeding in being absorbed, when the case is otherwise suitable for argentum nitricum with the close connection recognized today between vegetative gastric disturbances and the formation of ulcer it is understandable that argentum nitricum would prove it- self homoeopathically in functional gastric spasm as in gastric disturbances and the formation of ulcer it is understandable that argentum nitricum would prove itself homoeopathically in functional gastric spasm as in gastric ulcer. As the abdomen tends to meteorism, so the stomach is distended, with the sensation as though it would burst. In the gastric complaints there are frequent, tasteless eructations of air.
The evacuation of stools is accompanied by considerable flatus. The stools are diarrhoeic, at least, this is the most frequent action in the provings, and constipation is observed only in iso- lated instances as a late effect. The diarrhoeic stools are greenish and offensive, often (nocturnal) colicky pains precede. The diarrhoea is aggravated by sugar, for which a great desire exists, in spite of the fact that it is not borne well. Moreover the aggravation of the diarrhoea by drinking seems to have been clinically proven: diarrhoea as soon as the patient drinks; fluids seem to simply run through the stomach and intestine. For the nervous character of the diarrhoea speaks its aggravation through any mental commotion. That the disease lying at the basis of the diarrhoea in argentum nitricum is dysentery, typhoid, cholera, in which the remedy was formerly used by old physicians is in any case the exception. Better is the homoeopathic indication of chronic diarrhoea in children in whom there is a desire for sugar and a great emaciation and tympany is present.
The splinter-like pain in the urethra has already been mentioned in regard to the urinary organs. According to the provings there is also marked evidence of irritation in the urinary passages, with a sensation of swelling and ulceration, burning and cutting; also after dribbling of urine. One should recall through such symptoms the external use of argentum nitricum in gonorrhoea. For homoeopathic use these symptoms are not often employed although the first stage of gonorrhoea is cited as an indication. Not in the older provings but recently cited is an acute pain in the kidney region and along the ureter. By Americans this has given occasion for the treatment of renal colic due to stone. The oldest report that silver produces dropsy has led at one time to the question of nephrities, at another to hepatic cirrhosis. In many provings there is increased diuresis, frequent and copious evacuation of pale strongly smelling urine. Argentum metallicum is said to be useful in diabetes insipidus.
Initial increased and subsequent decrease of the male sexual impulse has obtained no clinical significance. In women the sensation of enlargement in the left ovarian region has been mentioned for argentum metallicum. Otherwise there are still single manifestations of increased rush of blood toward the genitalia; now transient appearance of bleeding between the menses, feeling as though the menses would appear marked sexual excitation. But these symptoms are rarely employed and best then in connection with states of nervous excitement, anxiety and restlessness in women at the menopause. Apparently taken over from the local actions of argentum nitricum is the indication in erosion of the cervix 648 with copious, yellow, excoriating leucorrhoea and frequent bleeding from the ulcerated sites. A symptom referring to this is also: bleeding from the vagina after intercourse.
Besides the outstanding influence of silver on the nervous system we have with argentum nitricum a series of irritative manifestations ions on the mucous membranes and indeed exactly on those on which the external application is common in school therapy (mouth and throat, stomach, urethra, cervix uteri). To these the mucous membrane of the eye must be added. There is a severe redness and swelling of the conjunctiva with profuse, yellow, purulent, bland secretion, the eye lashes are especially involved and the caruncula lacrimalis is swollen. The purulent granular conjunctivitis should be especially suitable for the homoeopathic use of argentum nitricum. It is also recommended in blenorrhoea.
In the affinity for the mucous membrane the nitrate fraction of silver nitrate is obvious. The increased nitrogen transformation gives a basis for the comprehension of the cachexia appearing after too prolonged use of silver nitrate. Thus there is a type which is particulary suitable for argentum nitricum: wasted people with pale, grey downcast facies or children who seem strikingly old. The progressive emaciation is an important indication n most argentum maladies which slowly progress.
1. Nervous system (holds for argentum metallicum as well as argentum nitricum).
Weakness of memory, restlessness, hastiness, anxiety (argentum metallicum involves the intellect, argentum nitricum more the disposition).
Headache in the left eminentia frontalis, sensation of enlargement; better from dorsalis.
Vertigo, epilepsy, tabes dorsalis.
Lancinating neuralgias, paraesthesias.
2. Mucous membranes (holds more for argentum nitricum).
Splinter-like pain (throat, urethra).
Hoarseness from straining the voice (argentum metallicum). Radiating gastric spasm (gastralgia, ulcer).
Diarrhoea, green slimy, worse from sugar, from drinking.
Progressively emaciating. Pale, grey, wasted.
Weakness of the entire left side, which is preferred in respect to symptoms.
Sensation of enlargement.
Splinter-like pain (argentum nitricum).
Desire for sugar which is badly tolerated (argentum nitricum).
Mental effort aggravates many complaints particularly the nervous.
Chief time of aggravation for argentum nitricum at night, for argentum metallicum morning and towards 11 A.M.
Special modalities, see above.
Argentum metallicum and argentum nitricum are employed between the D 3 and D 30. In gastric maladies D 5 and D 6 have proven useful for me, in central nervous maladies also the D 30.
(The lower potencies up to D 4 of argentum nitricum must be prepared freshly with distilled water.)
If one reads an old herb book, perhaps the “Hortus sanitatis” of Peter Schopfer written in 1485, then he finds: “the virtue of gold is heat and drying in the temperament, no master reports a degree of it because its virtue exceeds all herbs, roots, spices and metals.” Here we have also lying at the base, the Galenic theory of four elements and their degrees, which was useless for explanation of observations because it was purely speculatively conceived.