On the other side Starkenstein has depressed the chemosis of mustard oil in rabbits and the dionine chemosis in patients with salicylates (even if more slowly than by atophan) however without consideration of the influence of reduction of circulation and alteration of blood pressure.
The analgesic action in rheumatic fever finally may be ascribed partly to the lessening of inflammatory afflux into the joints, but this may also have a central origin, since the action has found numerous application in non-inflammatory pains. Whether the action occurs directly on the cerebral pain centers or via a detour over the vasomotor nerves, is still not known.
RESULTS OF SALICYLATE THERAPY —————————– If now the bacteriotropic action of salicylic acid in joint rheumatism is denied and a polysymptomatic effect recognized, then it is by no means determined whether the known action of clinically maximal doses on fever, swelling, and mobility of joints is curative, favorable in the sense of an accelerated recovery and avoidance of complications (as the cardiac affections), or a lessened incidence of fatality. These questions can be clinically-statistically investigated and further studied accordingly from the side of theoretic plausibility, which is based on experimental results.
The question of the avoidance or improvement of cardiac affections in joint rheumatism by salicylic acid in the usual doses is answered decidedly in the negative. An unfavorable influence of salicylic acid on the frequency and severity of heart affections is proposed by one series of observers, denied by another.
The possibility of cardiac damage in any case is not to be entirely dismissed. States of collapse with cyanosis and comatose dyspnoea are observed from large doses. In animals there is a transient increase from smaller doses, falling of the blood pressure and finally diastolic stanstill.
The influence of the duration of the disease is difficult to determine. If the fever was a definite point of departure then the question would certainly be decided in favor of the usual salicylate therapy. But it depends largely upon the subjective view of the physician when he considers a patient with joint rheumatism cured. According to Hanzlik, Scott and Gauchat 551 8 patient under salicylic acid had an average duration of disease (from 6-38 days), 9 days shorter than patients who received no salicylate. J.L. Miller 552 showed in a statistical study on 1907 cases with and 1600 cases without salicylates that the average duration of the hospitalization in patients with salicylic acid was the same as without it. He comes to the conclusion that treatment with salicylic acid in no way favorably influences the duration of disease and the tendency to recurrences and that a complete refractory situation against salicylates is frequent. Poynton and Paine, 553 R. Miller, 554 and Zadek 555 decide similarly that neither the involvement of other joints, nor recurrences nor heart complications are prevented by salicylate therapy and that reappearance is just as frequent in the treated as in the non-treated.
In another statistical by Hanzlik 556 18 Percent were not improved by sodium salicylate in large therapeutic doses or were incompletely improved, and that in the improved repetition of the salicylates was frequently necessary because of recurrence of the symptoms.
Swift, Miller and boots 557 sought to obtain an objective criterion for the influence of salicylates from the white cell counts. At times during the treatment with salicylic acid the white count fell to normal, with discontinuance of salicylates the number rose again, to 4,000 or more over the original state, a sign that the infection again existed. If one has in the leucocyte count a suitable criterion for a decision on the course of the disease with and without salicylic acid speaks against an increase in the defense of the organism in the fight against an increase in the usual doses of salicylic acid speaks against an unknown cause, much more for a weakening (entirely in contrast to the manner of action of non-specific irritant bodies which have been found curative in about 40 Percent of the cases according to American authors). In the sense of a decrease of the intrinsic possibility of defense through large doses of salicylates also speaks the experimental studies in animals. Swift 558 found in rabbits who had received streptococcus viridans (living and in vaccine form) and washed sheep erythrocytes, a reduction in the antibodies agglutinins, and hemolysin formation and the complement fixation under large doses of salicylates in contrast to control animals.
From animal experiments proceed even more significantly the results of experimentally produced arthritis in rabbits. Salicylic acid proves useless for the aviodance of arthritis from the injection of hemolytic streptococci. 559 In the arthritis from various types of streptococci, the animals die more frequently under salicylate treatment than the controls which had no salicylates. 560 Swift and Boots 561 obtained the same result with non-hemolytic streptococci. The animals which received salicylic acid before and during the infection died earlier than those without salicylic acid. It remains undetermined whether the view of the authors is correct, namely that the cause is a summation of the renal damage through the bacteria and salicylate.
Of interest was the finding on the severity of the joint inflammation. Approximately one half the joint inflammations (from streptococci of slight virulence) in the animals with salicylates were of a mild type, while the inflammation in the controls was severe. But nevertheless 36 Percent of the animals treated with salicylates died while only 8 Percent of the controls. The apparent local improvement also stood opposed to the unfavorable course of the general disease.
Accordingly the theory of etiotropy and increased intrinsic resistance by salicylic acid does not contain in its characteristic domain in the acute rheumatic fever, whereas one is confronted by the confirmed experience that in innumerable cases, salicylic acid can bring some of the cardinal symptoms of rheumatic fever to disappearance. The chief action of salicylic acid on the vasomotor and heat center and the central reduction of pain in general have a palliative value. Moreover a canalization especially through the sweat and kidneys in the sense of an alleviation of the healing endeavor is to be considered. But it is doubtful how far the organism is weakened in the active fight against the infectious excitor. These reflections hold for the great doses of salicylates (8-12 grams pro die). This does not exclude in any way that in single cases of rheumatic fever salicylic acid can be more than a palliative and that in single cases it may give permanent results. In the sense of a derived irritant therapy according to the symptoms, as homoeotherapy is, such results are to be expected when the effect picture of salic- ylic acid presents a similar picture. And this is actually the case. But the confirmation would first be brought when small doses (stimulant doses) yield a good result in these cases. This expectation must be realized still more when benzoic acid which is closely related to salicylic acid, is found often to be suitable in joint rheumatism in accordance with homoeopathic use. If an agent like benzoic acid, in provings on the healthy, produces many expressions in the human organism such as symptoms which are similar to those of joint rheumatism, small doses of it have been proven useful, so it is certainly not a palliative agent suppressing single symptoms, that is, it is directed not against the healing endeavors of the organism but conforms with them. With the provings of salicylic acid available up to the present this trend of action has not been sufficiently tested and even less investigated. That salicylic acid often produces sweats in the healthy and also high fever in those disposed, also occasionally springing pains in the joints with aggravation from movement and contact, moreover an urticaria related to that of rheumatism ( I recall here that the arthritis in joint rheumatism has been cons- idered as an allergic manifestation by Bauer 562 speaks for the possibility of a specificity in the homoeopathic sense. Between the extreme the specificity for the joint rheumatism (which can exist only in etiotropic action on the excitor) and the non-symptomatic symptom suppression, homoeopathy sees a specificity in the sense that the medicinal agent can be adapted to especially suitable single cases by comparison of the symptoms.
OTHER ACTIONS AND USES
The chief trend of salicylic acid on the nervous centers is also revealed in the well-known so-called untoward actions: pains in the head, vertigo, ear noises and difficulty in heating, nausea and vomiting.
In regard to the obviously vasomotor headaches, it is to be recalled that Wiechowski 563 found widening of the peripheral and contraction of the intracranial vessels in animals with sodium salicylate. Probably this is connected with the palliative action of salicylate preparations in headache.
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,