Further, it would not be contradictory to the above designated way in which sodium chloride produces fever, if the liver should have a special role. This has been assumed by some authors because Rolly has shown that sodium chloride fever appears only when glycogen is present.
Apparently very similar to NaCl fever are the relations between glycosuria and hyperglycemia which can be experimentally produced through NaCl. Here also it is probable that the disturbance in ion equilibrium is vegetatively conducted to the nerve centers. How far the connections to glycogen and to the other metabolic alterations are here related to large doses of sodium chloride is still undetermined.
SODIUM CHLORIDE DEPRIVATION
Perhaps the favorable action of sodium chloride free or sodium chloride poor diet, which has recently been so widely advised in various diseases (tuberculosis, lupus, migraine) through a number of food reforms, is to be based on the above-mentioned metabolic and ion relationships. NaCl deprivation would accordingly increase the CO2 tension in the blood, would displace the fixed acids in the blood and promote calcium ions. But it is also possible that other explanations will be found for this successful dietetic therapy.
The salt-poor diet in nephritis has another basis; it is a sparing and unloading therapy for water economy because in nephritis the capacity for excretion of NaCl is depressed or subnormal. Consequently, by the introduction of salt, the urinary output will be depressed and the retention of water and NaCl in such cases of retention of water and NaCl will favor edema. Deprivation of NaCl in such cases of retention often again increases the urinary output.
But in our discussion we can say little about the therapeutic actions of salt deprivation because we seek, as the basis of our therapy in the use of NaCl, positive actions, the tensions of the organism. On the other hand, we cannot assert that the diseases which are favorably influenced through salt withdrawal are caused by an excess of salt. The reason is that the withdrawal of salt might, and probably is a nonspecific procedure for the transformation of metabolism as a fast or thirst cure.
CRUDE SALT ACTIONS
A laic use is to take concentrated doses of salt in order to arrest hemorrhage, in particular hemoptysis. This has been supported by the reports of v.d. Velden that strong injections of sodium chloride increase the coagulability of the blood. (An increase of coagulation has also been reported for natr. sulf. by Reverdin). Whether therein a forcible re-orientation in water economy plays a role, perhaps the rapid excretion of sodium chloride with corresponding amounts of water out of the circulation into the tissues remains to be seen. In any case an antagonism against calcium does not come into evidence here since it is exactly the calcium ions which are necessary for coagulation and, moreover, it is not known that a subnormal concentration of calcium promotes coagulation, but indeed the contrary.
It is a crude action of salt when the secretion of sweat is depressed by the oral or intravenous use of NaCl. By this means the night sweats of tuberculosis can be removed for a short time. A water retention with the ingestion of NaCl by the tissues gives a close explanation but probably not the entire one.
In seeming contrast to the favorable action of NaCl deprivation in tuberculosis stand the not-to be denied results of sun baths, sea air and sea baths in torpid glandular tuberculosis. Here of significance is that the exudative diathesis shows an increased capacity for NaCl in the skin connective tissue. The slowing of NaCl metabolism in this important regulator can be removed through the external action of sodium chloride.
The excretion of alkali carbonates besides water from the sodium chloride water (as Wiesbaden, Ems) is claimed for the surface of the respiratory mucous membrane whereby there is a mild liquefaction of the mucus. So the alleviating action of this spring water has been explained in chronic catarrhs; the alkali fraction is the essential element here.
Sodium chloride increases the secretion of the saliva and gastric juice, an action on which its use and effect as a condiment depends. But not only hypertonic but also hypotonic solutions provoke an increased secretion of gastric juice, while isotonic NaCl solutions are without influence. On the contrary, the very salty foods again act depressing on the gastric secretion. To some extent the salt introduced at meal time is available for the production of HCl in the stomach. For the remainder, the necessary chlorides are taken from the blood and the CO2 tension of the blood increases during this withdrawal phase, as Cl and CO2 stand in an important exchange and equilibrium relation to each other. By excessive withdrawal of chlorides (for example, marked vomiting, with loss of HCl in pyloric stenosis) the alkalosis of the blood can increase so far that a gastric tetany occurs.
CL. ION AND ACID BASE EQUILIBRIUM
But for the maintenance of acid base equilibrium the chloride anion is just as important as the Na cation. Here NaCl is a ready reserve of great breadth and indeed, according to the requirements of intermediary metabolism, the paths of Na and Cl may separate. The Cl can easily be exchanged for the anions arising in metabolism as the carbonates and phosphates. Through is easy excretion, the chloride can spare the anions arising out of the oxidation of organic materials, but on the other side can easily lead to excretion if they are introduced in excessive amounts; then chlorides themselves may be held back. This reciprocal relationship, suitable for equalization, is indeed, only one of many for the maintenance of regulation of the intermediary metabolism. Such purely quantitative chemical processes are subjected to disturbances only under extremely unusual conditions and then only through mass substitution or massive deprivation. The acid base equilibrium in the body fluids is ordinarily not endangered. But if a one-sided demand is placed upon this regulation, perhaps on the chloride content of the organs cells, then functional disturbances will arise there So it might be considered that, through its exchange relationships with the anions of combustion metabolism and as it participates in a regulatory manner in oxidation processes, chlorides can be involved by disturbances in their course if they are excessively retained. These, then are the preconditions for a medicinal influence, perhaps, with a preparation of sodium chloride in which not the amount but the activity of the liberated fraction gives expression.
REGULATION OF NaCl METABOLISM
Such a medicinal influence would, however, be scarcely possible if it had to be exerted directly on the tissues and the receptive organs. The disturbances of Na and Cl economy notoriously occur in them, but a direct medicinal alteration simultaneously at so many points is hardly probable in itself. Actually underlying the normal NaCl metabolism is a central regulation which is mediated partly through hormones, and is partly of a pure nervous variety.
One knows that the storage in the tissues (chiefly in the subcutaneous connective tissues with the two passages of discharge, to the blood and to the outside in sweat) as well as the excretion is extensively influenced by the vegetative nervous system. Very distinct is the influence of the vagus on the formation of gastric HCl. Subordinate centers for the nerve control exist in the medulla oblongata and in the inter-brain. The so-called salt-puncture in the floor of the 4th ventricle (vagus nucleus) effects an excessive excretion of salt, under certain conditions without the participation of water excretion.
Of the endocrine glands the most important regulator of NaCl economy is the hypophysis. Hypophysin causes a streaming of NaCl fluid out of the tissues into the blood and increased NaCl excretion, even in the first phase which proceeds with a sparing of water. In the second phase the excretion of both water and chlorides is increased.
In hypofunction of the thyroid, chlorides are retained in the tissues, and by doses of thyroid the chloride stream from the tissues into the blood and the excretion is increased. Reversely adrenalin effects a chloride retention in the tissues. The influence of insulin seems to be indirect through its influence on water economy and acid formation.
Thereby the importance of the endocrine system for NaCl metabolism is demonstrated, but a uniform trend in the meandering paths of hormones and vegetative nerves is still not distinct. Therefore the manner of action of sodium chloride as a drug remains almost completely shrouded in darkness. The physiologic role of NaCl as a regulator of water economy and the acid base equilibrium in metabolism and the depicted results of disturbances in the NaCl economy make it possible for us merely to outline the field with rough borders in which a medicinal excitation through preparations of sodium chloride seems possible. Only the investigations with such preparations in sensitive men with a labile NaCl balance will permit us to find further helpful indications for the employment as a drug.
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,