The study of Nobiling with tartar emetic deserves more detailed presentation: “If tartar emetic is given internally in small doses increasing from 1.12 mg. then the following manifestations become evident by degrees: pressure and heaviness in the precordial, heavy dull head, discomfort, restless excitable disposition, soreness of the extremities especially the thigh; tearing and drawing in the joints, febrile chills, accumulation of saliva in the mouth, pasty mucous coated tongue, thirst with internal heat, particularly congestions toward the head, great lassitude and malaise, therefore also great tendency to sleep, with anxious dreams, frequent irregular full pulse, vertigo, flickering before the eyes, tired, sad, sunken eyes which are surrounded by dark circles, pale downcast face, increased collection of mucus in the throat and sensitive swallowing. If used for a longer time the appetite diminishes, pressure in the stomach causes great sensitivity, severe, sticking, frequently recurring pains of short duration in the intestines, nausea, anxiety and frequent irresistible yawning are added; respiration becomes labored and on the chest and around the region of the heart an unpleasant anxious sensation occurs. On the skin of the back a sensation of cold makes itself unpleasantly obvious and then extends to the legs. The abdomen is somewhat distended and extremely sensitive to contact. At first the stool is normal, but gradually becomes irregular, often pasty, but at times solid and in the intervals there is constipation. In consequence to the marked drinking of water which the the insipid taste in the mouth makes necessary, the urinary output is increased, thereby is the urine clear and watery but is hardly altered in its chemical characteristics.
If tartar emetic is used for a longer time and in gradually increasing doses, then all the manifestations appear in greater degrees. The nausea increases to severe vomiting, frequent eructations and belching, the stool becomes a thin, muco-bilious diarrhoea with a tense, distended abdomen which is sensitive to contact. The gastric but particularly liver region is distended, the liver dullness on percussion is increased about a finger’s breadth downwards, in marked cases the liver is palpable under the ribs and very sensitive on pressure. Colic and rumbling develops in the intestine with tearing, cutting and pinching in the abdomen, with tension and tearing in the lower extremities. The sensation of warmth over the entire skin surface is increased and there is itching. The appetite
is entirely lost and if something is eaten then the nausea is renewed and there is the inclination to vomiting. The throat becomes rough, swallowing impaired and very sensitive. The tongue is covered with a dirty slimy yellow coating, the taste is insipid and pappy. The secretion of mucus is increased and in the chest, stasis becomes noticeable in the lesser circulation. The head is heavy, pressing, dull and extremely painful in the frontal and vertical regions.
With small continuous doses there is lessened force and slowing of the heart and consequently of the pulse; the heart beats to a diminished degree but with a distinctly perceptible lesser intensity at the normal site. Respiration is labored and likewise slowed; the face is discolored; weakness extends over the entire body; emaciation occurs and with this the deep position of the eyes and the difficult movement of the extremities is explained. The vomiting is usually accompanied by a copious outpouring of cold sweat over the entire body, but large drops appear on the forehead, and this is accompanied by flickering before the eyes, weakness and vertigo.
RESULTS OF ANIMAL EXPERIMENTATION
The animal investigations available for explanation of antimony action give only a very defective picture of the intermediate processes. The similarity with arsenic is great, still the action is less severe and slower. The peculiarities of antimony are not apparent from investigations arranged on animals, so that we must depend entirely on human provings for these.
The metabolic actions of antimony seem to be similar to those of arsenic, still the scanty findings available at present are contradictory. Chittenden and Blake found by prolonged feeding of Sb2O3 in pigeons an increase of weight and a large fatty liver, in rabbits a decrease of weight. In a dog with a fixed normal diet they found no essential alteration of the protein metabolism by the use of Sb2O3. On the contrary Gathgens found in a hungry dog to whom tartar emetic was given, a considerable increase in nitrogen excretion and a slighter one of sulphur and phosphorus so that an increase of protein transformation of about 30 Percent was assumed.
The glycogen of the liver under antimony very markedly diminishes and may vanish completely. As with phosphorus and arsenic the CO2 content of the blood, falls, obviously here the result of an acidosis from disturbance of the carbohydrate and protein metabolism.
In the blood at first appears a leucopenia and eosinophilia and then a leucocytosis follows. The reports regarding th red blood cells are indefinite, Kolle and his co-workers observing after chronic poisoning in mice a marked decrease of the erythrocytes and poikilocytosis, which recalls the action of atoxyl. Mayerhofer found the coagulability of the blood markedly reduced. The blood pressure sinks gradually and continually and in chronic poisoning one finds also a slight reduction. This fall is not simply the result of cardiac weakness, because by arotic compression and under helleborein there still occurs an increase of pressure. The fall in blood pressure is the result of vascular paralysis primarily in the abdominal capillaries. In acute poisonings there is cardiac standstill in diastole.
A stimulation of respiration in acute poisoning from tartar emetic has been traced by Grimm to an immediate action on the respiratory center.
The typical vomiting which appears not only with tartar emetic but also from other antimony preparations also occurs after intravenous introduction whereby the vomitus contains antimony. According to Hermann the vomiting is not the result of an immediate central action because greater doses are necessary for its production intravenously than by mouth. The vomiting is regarded as released reflexly from the gastric wall and indeed by the antimony that has been excreted also after intravenous administration. According to the investigation of Wesis and Hatcher on cats the vomiting movements appear after intravenous injection and even after removal of the entire gastro-intestinal tract. According to them the action probably proceeds over the vagus (whose sensory nucleus is essentially concerned with the act of vomiting), and to a lesser degree over the sympathetic. These authors hold it as probable that by intravenous injection the heart comes into consideration as the site of origin for the vomiting reflex and from there, as well as from the stomach and duodenum for the most part over the vagus and only to a slight extent over the sympathetic, the centripetal stimulus for vomiting passes.
An influence on the vegetative system is also suggested by the observation of the angioneurotic manifestations in the antimony therapy of multiple sclerosis.
Apart from these central and vegetative actions, antimony has no essential significance for the central nervous system. With fatal antimony poisoning the reflexes are lost and even if the vessels are ligated before the intoxication. Accordingly the disturbance does not arise from the spinal cord. On the other hand Michiels found no alteration of reflex excitability. According to Soloweitschyk the irritability of the nervous system persists after cardiac standstill. In the beginning of the intoxication an irritant state of the medulla is observed, then the reflex excitability is diminished. But the voluntary movements may persist. The irritability of the motor nerves and voluntary muscles is also maintained.
Occasionally the remark is found that antimony aggravates pulmonary tuberculosis, but that with small doses the therapy of lung tuberculosis can be assisted in that it acts as a “tonic” on the total organism.
ANTIMONIUM TARTARICUM
Provings of Antimon. tartar. are found:
1. Stapf: Arch.f.d.hom. Heilk, Bd. 3, H.2, p. 146, 1824.
2. Mayerhofer: Heller’s Arch.f. physiol. u. path. Chem. u. Mikr., 3Jg,. p.111, 1846.
3. Nobling: Ztschr. f. Biol,. Bd. 4, p.40, 1868 (see above)
4. Ackermann: Ztschr. f.ration. Medorrhinum von Henle u. Pfeiffer, Bd. 2, p. 241.
5. Boeker: Beitr.z. Heilk, Bd. 2, p.324, 1849.
6. Molin: Des specifiques en medicine, Paris, 1847.
All antimony compounds unfold their chief action on the mucous membranes, particularly of the gastrointestinal canal, the respiratory passages and on the skin. But in use the preparations are differentiated by elective organ trends.
RESPIRATORY ORGANS
With tartar emetic, antimon. tartaricum, the emetic action of large doses is not guiding but the milder action which stamped the agent as an expectorant even in antiquity. This old empirical use became discredited only because of unsuitable doses. While the aim with larger doses proceeded on the basis of increasing and relieving the scanty and tenacious sputum of bronchitis, the homoeopathic use is much more extensive in massive collection of mucus which is difficult to evacuate. In bronchitis, bronchiolitis, bronchopneumonia and threatening pulmonary oedema, the cardinal symptoms of tartar emetic loud, rough rales in the air passages has been proven ever again. The chest seems to refill constantly with foamy mucus. At the beginning the patient can evacuate some tenacious light, white mucus by retching, but finally he is unable to do so, an asphyxial state impends and signs of collapse with cold clammy sweat, white ala nasae and hippocratic facies (entirely as with arsenic) is noted. Antimon. tartar. is especially suitable for small children and old people with recurrent bronchitis, in whom tracheal rales and dyspnoea, finally sleepiness through the excess of carbon dioxide, dullness, lassitude and sweats appear. The increasing weakness expresses itself in the type of cough: attacks of coughing decrease slowly in duration and severity with increasing weakness; the cough alternates with yawning. In emphysema attended by bronchial asthma tartar emetic competes with arsenic. “Cannot lie down because of dyspnoea” is a symptom common to both. The old patient must sit up; there is a great desire for fresh air even though the skin is cool as a result of the impaired circulation. The child wants to be carried upright; they are anxious and peevish because everything bothers them; they will not be touched, etc. Owing to the defective power of reaction then fever in antimon. tartar. patients generally is not high; chilliness prevails.
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,