In the severity of cell action, the firmness of combination, the generality of effect possibility and the preference for the parenchymatous cells, arsenic can be best compared with the most virulent toxins of many bacteria; therefore the great similarity of the arsenic picture with cholera, with acute sepsis as well as those with a more protracted course.
The similarity to sepsis can serve at first for enlightenment of certain general actions of arsenic.
COMPARISON WITH SEPSIS
In sepsis as in arsenic we see the high grade weakness, so difficult to explain by tissue sections, increasing anemia from diminution of the erythrocytes and of the hemoglobin. The anemia, in arsenic has an entirely toxic degenerative note and between the degenerative anemia and the fatty degeneration of the organ and endothelial cells certainly exists some connection because the fatty degeneration is observed especially in pernicious anemia. The extreme anxiety and restlessness in addition to the great weakness, and the feeling that death is inescapable, one finds in arsenic in sepsis. The chills in sepsis correspond to the periodic chills and the so-called cold fever in arsenic. The periodicity cited as so characteristic for arsenic is not strict but depends upon the periodicity of metabolism. It expresses itself in a chief time of aggravation namely from midnight to two in the morning. The great feeling of coldness, the desire for warmth the improvement from warm drinks, corresponds to the collapse phase of sepsis (and cholera) and is also more peculiar to the acute arsenic picture while the mild vasomotor phenomena, as headache, improvement from cold have and what suggests the congestive nature of these aggravation from lying down. The cold sensation of arsenic apparently has less constitutional character than an acute, and this modality is not universal, but merely, similarly to phosphorus, is present in a reversal to some other condition. The great thirst of the arsenic picture is characterized by frequent ingestion of only small amounts of fluid. This corresponds to the great restlessness in which, just as in sepsis, the organism is found in an acute arsenic status. In the more chronic states, absence of the thirst is not a contraindication to arsenic.
The similarity of arsenic and sepsis can be followed further in respect to the manifestations in single organs. If one recalls the malignant, septico-gangrenous anginas and oral inflammations, the parenchymatous nephritis, as they occur in sepsis and scarlet fever just as they do in arsenic, then one frequently finds a suitable remedy for them in arsenic; in the toxic but still therapeutic cardiac action, myocarditis, dilation with arrhythmia, bad pulse, lowering of the blood pressure and coldness of the body, as well as endocarditis; in the splenic swelling, in the erythematous and at times petechial skin phenomena, all of which refer to the septic character and to arsenic as a suitable remedy. A toxic herpes zoster with the characteristic burning pain also falls in the field of indications of arsenic and also appears in sepsis. To these are added the septic and phagedenic ulcers of arsenic on the skin and mucous membranes which tend to become gangrenous, likewise with burning pain, the corneal ulcer. Ulcera cruris has more a trophoneurotic character; its black base, the flat extension in width, indicates the poor tendency to healing. Thrombophlebitis and septic-embolic foci suggest arsenic as one of the most important remedies.
Such a comparative consideration shows that arsenic has been an important remedy in sepsis in homoeopathy but is in no way always the remedy. Here the character and rhythm of many arsenic symptoms should be distinctly comparable. It is worthy of note that (according to Gies) arsenic is considered an antidote to snake bite among the Brahmins.
COMPARISON WITH CHOLERA
The comparison of the most severe gastro-enteritis of acute arsenic poisoning to the picture of cholera is likely. Even Virchow could not differentiate between arsenic poisoning and cholera from the pathologico-anatomic findings. The signs of arsenic are: rice water stools, great lassitude, severe colic, cardio-vascular collapse, cramps in the calves, ice cold body, fear of death, aggravation of the diarrhoea and of the vomiting from eating and drinking as well as at night, with burning thirst, aggravation from cold drinks which are vomited immediately, improvement from warm drinks and the application of other forms of heat. If convulsive phenomena appear, then cuprum arsenicosum will be preferred. The comparison is naturally drawn only to the picture and not to the diagnosis. In cholera infantum arsenic or an arsenical compound is frequently in place, but it can, for example, be just as well indicated in the similar botulism or paratyphodial diseases, also in gastro- enteric conditions with less severe total pictures which are provoked by cold foods or drinks or spoiled foods. The diarrhoeas are always extremely offensive, at times bloody, very exhausting, so that a dysentery-like picture comes into consideration for arsenic. The abdomen is sensitive to pressure and distended. Throughout the entire gastro-intestinal canal a severe burning pain prevails, thus, for example, in the markedly inflamed hemorrhoids in which the nocturnal aggravation and the improvement from warm applications furthermore suggest arsenic. Cold foods and drinks cause gastric pain, vomiting, and diarrhoea. The great weakness and the other modalities are always guiding.
OTHER MUCOUS MEMBRANE SYMPTOMS
The gastro-intestinal canal syndrome in arsenic need not manifest septic and toxic trend which corresponds to cellular and capillary damage. Thus arsenic can be helpful in gastric ulcer with burning pain where in all probability vasomotor-trophic causes rather than toxic causes play the chief role. The following gastrics symptoms of arsenic can have gastritis as a basis: pain after eating and drinking, sour burning and eructations of sour and bitter but very acrid fluid, loss of appetite, great aversion to food, can hardly bear the sight or odor of foods, longing for acid and coffee.
On other mucous membranes and organs the transition from organically inflamed to vasomotor disturbances in arsenic is still more distinct. Thus in the respiratory organs there is less often septic lung inflammation or pulmonary gangrene; likewise catarrhs of the respiratory passage (with dry cough, pain in the chest, aggravation after midnight, from drinking and in cold air) are rarely arsenic indications; more frequent are the asthmatic states with the typical time of aggravation, anxiety and restlessness and the inability to remain recumbent, accompanied by a dry hacking cough and a sensation of oppression and a scanty foamy expectoration. Hahnemann cured himself of a threatening suffocative catarrh which was aggravated each night after lying down by the use of arsenic. It is also not excluded that a chronic bronchitis with emphysema lies at the basis of the asthma. Moreover the nervous allergic forms of asthma react very well to arsenic which then is naturally given in the higher potencies. For explanation one can refer to the heightened irritant state of the respiratory center in arsenic poisoning; moreover the early action on the capillaries which is associated an abnormal permeability can also be made responsible. Finally the eosinophilia and the leucopenia under arsenic are signs of a simultaneous action on the autonomic system.
On the nose an actual inflammation with thin watery, acrid secretion is present with burning and sneezing without relief; but also the allergically precipitated hay fever or the vasomotor rhinorrhoea is a good indication for arsenic. In any case the aggravation in the open air holds more for the latter form.
On the conjunctiva exactly the same situation prevails. The burning and acrid lachrymation are guiding. Blepharitis with chronic reddened, swollen, desquamating lid borders appear at times and corneal ulcer frequently comes into consideration for arsenic. On account of the trophoneurotic effect character one would think of arsenic first in herpes cornea.
On the female sexual organs are septico-ulcerative inflammations with burning, thin, acrid, corroding offensive leucorrhoea the chief indication. The inflammation can also proceed from the ovary and there is a burning pain in the ovarian region and a tendency to profuse and too early menses and to metrorrhagia. The relation to carcinoma of arsenic is naturally important for this organ.
CIRCULATION
Arsenic is suitable not only for the already mentioned severe organic states of the heart with insufficiency and arrhythmia but also for milder disturbances such as precordial anxiety, worse, at night, palpitation with restlessness anxiety and loss of strength in vasomotor lability.
The tendency to oedema in the arsenic picture will be ascribed not only to myocarditis and nephritis but also to the direct influence on the capillaries which leads to greater permeability. In nephritis it is also the acute and subacute forms proceeding from the capillaries which are suitable for arsenic.
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,