SUMMARY
Chief Trends: 1. Stomach-intestine.
Gastritis, gastro-enteritis.
Thickly coated white tongue.
Aggravation from acids but desire for them; from cold baths and washing; from radiant heat.
Mucous outpouring in proctitis and hemorrhoids.
Summer diarrhoea in children; vomiting of milk.
Chronic: diarrhoea alternating with constipation.
Stool: liquid with small solid particles.
Headaches and mental symptoms dependent upon gastro-intestinal phenomena.
Children: fretful, peevish; adults: lack of will power, sleepy, relaxed.
Soreness and stiffness of the muscles, likewise dependent upon gastro-intestinal phenomena or alternating with them.
(Obesity doubtful.) 2. Skin: Rhagades at muco-cutaneous borders.
Itching eczema. Urticaria from gastro intestinal disturbances.
Thickening of epidermis, especially soles of feet, painful gait. Disturbances of nail growth.
Modalities: Worse from overeating, from acids, wine, cold water, radiant heat.
DOSE: The usual potencies are 3-6 (trituration).
ANTIMONIUM SULFURATUM AURANTIACUM
Provings of antim. sulf. aur. are found: 1. Mayerhofer: Hellers’s Arch. f. physiol. u. path. Chem. u. Mikr., Bd. 3, p. 356, 1846.
2. Boecker: Beitr. z. Helik., Bd. 2 p.93.
3. Neidhard: Hahn. Monthly, Bd., 16, p.649.
Antimonium sulfur. aurant. has entirely similar symptoms from the stomach and skin as the other antimonials, but is used almost exclusively for diseases of the respiratory passages. The manifestations are similar to those of antimon. tartar., only of a more chronic and less severe type, they also involve the upper respiratory tract more. Obviously the antimony in the more stabile Sb2 S5 comes into action with greater difficulty. Outside of the collection of tenacious mucus in the bronchi with oppressed respiration (worse night) the larynx and the naso- pharyngeal space shows more involvement; much mucus collects there and the sense of smell is impaired.
OTHER ANTIMONY PREPARATIONS
Antimon. arsenicosum was briefly proven by Isnard but its use is largely empirical in outspoken emphysema with marked dyspnoea and cough and abundant production of mucus, in hypostatic pneumonia (as antimon. tartar.), moreover, in exudative pleurisy.
Aethiops antimonials, outside of the above mentioned indication of A. Stiegele, has an empiric reputation in scrofula, particularly the severe scrofulous ophthalmias, D 2-D 15 (aethiops mineralis does not contain antimony but is a trituration of mercury with sulphur with partial combination). It is also empirically employed in scrofula.
DOSE
The lower potencies (triturations) of antimon. sulfur. aurant. and ant. arsen. are common, but of the latter, not below the third.
BISMUTH
The name bismuth is derived from “Wisemut”, originating from the idiom of mountain folk, according to Paracelsus, “since it blooms as a beautiful meadow on which all types of colored flowers stand”. Probably it is the “marcasita” of the middle ages. Even in the 15th century Basilius Valentinus mentions it as a metallic substance. It appears sporadically in nature, usually being found in common with arsenic, also as bismuth oxide (Bi2O3) and bismuth sulphide (Bi2S3).
Chemically bismuth stands very near to antimony, corresponding to its position in the periodic system but still bismuth has definitely the properties of a heavy metal and thereby approximates the heavy metals in its actions. In the nitric acid salt, Bi(NO3)3, bismuth appears as a trivalent cation. This salt breaks down in water to the basic bismuth nitrate, bismuth subnitricum (formerly called magisterium Bismuthi). This white powder, insoluble in water, does not have a perfectly constant formula but in any case it contains bismuth in the bismuthyl form (BiO), perhaps also bismuthyl hydrate (BiO)OH.
Bismuth subnitrate is the most common preparation in pharmacology. The bismuthyl salt may be compared best to the antimonyl salt, antimonium tartaricum. But the bismuth salt like most heavy metals is much less susceptible to absorption. The poorly or insoluble bismuth salts may be considered as not absorbed by the unbroken skin or mucous membrane. Moreover it is probably taken up from granulating wounds and catarrhally inflamed mucous membranes. On the other hand fresh wounds transform these compounds into soluble forms and induce manifestations of poisoning.
ABSORPTION AND POISONING
One may well assume that a minimal absorption may occur from the intact mucous membrane, similarly as with other heavy metals, for example, iron. The absorption is assisted if, from the start, the size of the particles is diminished by trituration. Only one need not expect the severe toxic manifestations from a few milligrams. But it is worthy of note that recently bismuth subnitrate has been relinquished in the treatment of gastric ulcer because of the possible manifestations of intoxication and bismuth carbonate recommended in its place.
After the introduction of large amounts bismuth is found in the liver, spleen kidneys, intestinal wall, salivary glands and bones. Excretion occurs in the urine, faeces, saliva, intestinal glands and milk. Thereby the channels of excretion through the intestinal glands, saliva, and urine are noteworthy for explanation of the toxic actions observed.
In animal investigations (in the dog) the manifestations of acute poisoning from intravenous administration; Vomiting, barking, twitching and death. With more chronic intoxication, vomiting, loss of appetite, diarrhoea with tenesmus; the temperature falls to 34o, increasing weakness, there is reduced sensitivity, twitching of the facial muscles, fall of blood pressure and it cannot be raised by splanchnic stimulation or artificial asphyxiation; tetanic spasms, disturbances of coordination and increasing paralysis are frequently observed.
The milder states of intoxication in man consist of lassitude, loss of appetite, tendency to vomit. The bowels are somewhat constipated. Furthermore develop; burning in the throat, persistent vomiting, thirst and diarrhoea, then intermittence of the pulse, cyanosis, dyspnoea, etc. Moreover a state appears which closely recalls that of mercury: purulent oral inflammation, ulceration of the mucous membranes, loosening of the teeth, formation of a dark area on the margin of the gums; after healing, the scars of the ulcers show often a black base; the oral mucous membrane is loosened, marked salivation appears, the salivary glands swell and swallowing is impaired. Likewise intestinal catarrh and nephritis (or much more nephrosis since it is especially the tubular apparatus which is involved) are entirely the same as with mercury poisoning.
Anatomico-pathologically are found: the large intestine is colored black and contains necrotic foci: stomach and intestine, macroscopically, a relatively normal appearance but they may also show severe hemorrhagic ulcerated appearance. In the large intestinal mucosa are found many bismuth containing leucocytes. (According to Kobert bismuth penetrates the white and red blood corpuscles and leads to their destruction and haemosiderin deposit in the liver and spleen). Moreover, the liver shows hyperemia and parenchymatous inflammation, slight fatty degenerative infiltration. The liver glycogen diminishes from the use of bismuth. There is slight fatty infiltration in the heart; the kidneys show parenchymatous alterations and deposits of calcium carbonate and phosphate.
ANIMAL INVESTIGATIONS
Animal experimentation up to the present has contributed very little to the clarification of the intermediate processes in bismuth poisoning. The most important findings are the following: action on the erythrocytes: in dogs following the subcutaneous injection of bismuth there is a transient slight decrease in the red cell count and the hemoglobin value. In the urine a few erythrocytes, which does not explain the decrease. In spite of larger doses of bismuth which cause a loss of weight, no further diminution of the red cell count occurs. Of small doses of 1:20,000 of a 12.3 Percent bismuth containing preparation there was a distinct increase of the resistance of the red blood cell, with larger doses a hemolysis. According to Mendola it should favor the output of new white blood cells while the red cells in rabbits remain unaltered.
On the heart a decrease in the rate has been observed and a peristaltic pulsation, in mammals also the heart beats are grouped. It often stops for 90 seconds and then beats again. The blood pressure falls, likewise the rate. The grouping of beats suggests an action upon the cardiac ganglia, and action not dependent upon the vagus since cutting the vagus has no influence.
That on the central nervous system initially excitation and increase of irritability and then paralysis is observed means but little since this is observed in animal experimentation from nearly all metals. In the frog there is an excitation of the centers in the medulla and which extends from above downward over the entire cord so that reflex tetanus on touch appears.
The similarity of bismuth poisoning with that of mercury (oral and intestinal inflammation and nephrosis) has given occasion for mercury poisoning which has also been elaborated for mercury poisoning by Almkvist. It involves precipitation of the metallic oxide by hydrogen sulphide in the cells and vessels. An occlusion of the vessels will be occasioned through the precipitation in the finest capillaries of the intestinal wall. In any case the presence of H2S markedly influences the excretion of bismuth. If sulphur is administered to a bismuth poisoned animal, then the stomach and intestinal wall show a dark discoloration and ulcers appear. On the other hand after formation of H2S in the intestinal canal, the introduction of bismuth compounds by mouth cause only slight discoloration and no formation of ulcers. This close connection of sulphur to heavy metals is certainly not without significance for the site and grade of effectiveness. In this respect however one observes bismuth damages without the appearance of H2S. The epithelial cells of the small intestine, liver and kidney cells where hydrogen sulphide is not known to play a role may be damaged by the excretion of the metal.
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,