SUMMARY
Rapid and short acting agent.
Chief Trends:
Convulsive states, epileptic, uremic, tetanic attacks (palliative) Spasm of esophagus, “drinks roll audibly through the esophagus”; diaphragmatic spasm, sensation of constriction. Scratching in the throat with spasmodic cough. Laryngismus.
Transition or collapse. Precordial anxiety. Cyanosis and icy coldness.
DOSE The D 6 is the common preparation.
ACIDUM OXALICUM
Oxalic acid COOH. COOH (or sorrel acid because it is found in large amounts in the wood sorrel, oxalis acetosella) occurs as the calcium salt in many green plants, for example, sorrel, rhubarb and spinach. The absorption from the plants depends upon how much calcium is simultaneously present in the intestine. Because calcium oxalate is not absorbed from the intestine. The greatest part is destroyed by intestinal bacteria and burned to CO2 and H2O. But there are also bacteria in the intestine which can form oxalates from the foods (bacterium oxalatigenum). The fungus, aspergillus niger, can form oxalic acid out of carbohydrates. While oxalic acid in the test tube is easily burned by oxidizing materials, it cannot be split and burned in intermediate metabolism. In the human urine it appears normally in amounts of 15-20 mg. But it need not be precipitated in the form of the well-known crystals of the sediment as calcium oxalate but may also be dissolved. This depends upon the colloidal state of the urine. A small amount of oxalic acid will also be formed endogenously in the animal body and indeed probably in the splitting of glycocoll 580 from connective tissue. By feeding limes the oxalic acid in the urine can be increased.
The formation of oxalate concretions in the urinary passages depends upon many other physical and chemical conditions outside of the quantity of oxalic acid introduced with the plants. The indestructible calcium salt causes no peculiar toxic manifestations but only an irritation of the urinary passages which is associated with an oxaluria.
POISONING
As is generally known most poisonings occur from potassium oxalate, COOK.COOH. The corrosive action on the gastro-intestinal canal is not different from that of the mineral acids. The prolonged vomiting may be bloody, the diarrhoea also; esophageal distress and radiating pains in the epigastrium are accompanied by precordial anxiety, slowing of the pulse, dyspnoea, twitching of the muscles, lassitude and vertigo. In other cases the resorptive toxic effects appear very rapidly into the foreground; fainting, loss of consciousness and collapse; in longer delayed poisoning there is crawling and numbness in the extremities and headache. Urinary complaints and strangury are associated with the excretion of oxalates, but pain in the kidney region, nephritis with oliguria or anuria, hemoglobinuria and other severe results also occur. In these cases the kidneys are infarcted by oxalate concretions.
Poisoning with oxalic acid its salts is often explained as a calcium precipitation or deprivation exactly as the poisoning with other calcium precipitating acids, for example the related citric acid. The arrest of coagulation of the blood by alkali oxalates and citrates through removal of calcium ions is known and indeed used for many investigations (for example, the sedimentation velocity). In the severe poisonings the muscle contractions, the cardiac damage, perhaps also the nerve actions, signify simply a calcium precipitation process. 581 And for the flooding with large amounts of oxalic acid, the calcium salt for chemical combination is a useful antidote. But whether the less severe disturbances from smaller doses occur by withdrawal of calcium is still not certain. A product which develops physiologically in the protein splitting of supportive substance may also have immediate actions on the metabolism of this supportive tissue.
PROVINGS
The provings of oxalic acid are found:
1. Reil: Hom. Vierteljahrsschr., Bd. 2, p. 305, 1851.
2. Hering: Ameriken Arzneiprufungen, S. 525, 1857 (here also the earlier ones).
DRUG PICTURE
The local irritative manifestations on the gastrointestinal canal and urinary passages give fewer therapeutic indications than the symptoms reported from the nervous system.
Here first are the neuralgias. They appear paroxysmally in circumscribed small places or as cutting pains throught the arms and from the back over the thigh. Many paraesthesias, crawling, numbness, prickling, coldness occurs in the back or in the extremities, like-wise itching. On the skin are patches of marbled livid appearance. Hands and feet are cold as if dead; coldness runs along the back. There is also a great feeling of weakness as if the back was too weak to support the body. The feeling of crushing in the testicular and spermatic cord neuralgias is particularly stressed. Oxalic acid is also to be considered for organic diseases of the cord and a modality which holds not only for the neuralgias but also for the cardiac and urinary symptoms obtains here: the psychic influence predominates over all irritative symptoms; all complaints are aggravated by thinking about them; attentiveness to complaints. Moreover in general movement aggravates. The pains are often considered as rheumatic and the connection of oxalic acid to protein metabolism of the supportive substance permits this possibility to remain open.
The severe cardiac symptoms of poisoning have their predecessor in severe palpitation which is worse at night on lying down. When thinking about the heart, the pulse intermits. A connection with rheumatism is thereby not particularly probable. Sudden stitch in the cardiac region interrupting breathing, in view of the other characteristics of the remedy, need give no occasion for including organic diseases of the heart, pleura or lungs in its field of action.
In the stomach burning pains and sensitiveness to contact, in the abdomen pains and burning in small areas are noted. The diarrhoea is said to be produced by coffee; neither the diarrhoea with colic about the umbilicus nor the tormenting vomiting of poisoning gives any special point of departure for the selection of acidum oxalicum. The headaches are said to be worse before and during the stool (afterwards better?). The use of wine aggravates the headaches. Strawberries are apparently not tolerated.
The irritative manifestations in the urinary passages have led to therapeutic use when the urgency and pressure of urination is renewed by thinking about it.
SUMMARY
Chief Trend:
Neuralgia, paroxysmally at circumscribed places. Paraesthesias. Cutting pains. Weakness of back. Spermatic cord neuralgia.
Modalities:
All complaints worse thinking about them. Worse from movement. Palpitation on lying down.
(Diarrhoea worse from coffee. Headache worse from the use of wine, worse before and during stool.)
DOSE —- This rarely used remedy is recommended usually in the D 6 but also in D 12 and D 30.
Cerium oxalicum, the oxalate of the only rare earth which has been therapeutically used to the present, is not proven but in the lower triturations has been recommended in hyperemesis gravidarum and other forms of reflex vomiting and cough. The action does not seem to be very useful.
ACIDUM CITRICUM
Citric acid, CH2.COOH-C(OH)COOH-CH2.COOH, produces experimentally very similar intoxications to those of oxalic acid and which are also traced back to calcium precipitation; however in man the poisoning from internal administration is very rare. The corrosive action is not particularly great.
The action of the juice of citrus fruits in scurvy cannot be ascribed to the citric acid but only the vitamine content. But on the other side a case of scurvy has been reported from the excessive use of citrons for the prevention of yellow fever. 582 The tendency to bleeding is increased by the excessive use of ju- ice of citrus fruits. The reduction or prevention of coagulation of the blood by sodium citrate is generally known. In those who are sensitive, citric acid can produce vomiting and headache.
Citric acid itself is not proven. So only the external use of citrus juices for the pain of carcinoma of the tongue and the internal lay use in chronic rheumatism, dropsy and menstruation need be mentioned.
ACIDUM TARTARICUM
Tartaric acid, CH(OH).COOH-CH(OH).COOH which appears in many fruits, especially in grapes, produces inflammation and irritation of the digestive passages with burning as if from fire and drawing pain in the soles of the feet particularly near the heel after the ingestion in large amounts. 583 Outside of the neutralization in poisoning with alkalies, tartaric acid is not used therapeutically. Also in homoeopathy, neither it nor the potassium salt, cream of tartar, has obtained significance.
ACIDUM LACTICUM
Lactic acid, CH3.CH(OH).COOH, oxypropionic acid, develops from sugar through fermentation. It is found in many foods (sour milk, sauerkraut, cucumbers) and is formed in the stomach during fermentative processes. There is a dextro- and laevo-rotatory from as well as the racemic mixture of both. The dextro-rotatory form develops in working muscle from the fermentative splitting of glycogen and with phosphoric acid plays an important regulating role in the production of muscle contraction (see p.454). Moreover lactic acid can also form during protein splitting.
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,