The Nitrogen



ACTIONS ON THE BONY SYSTEM

Animal investigations and correspondingly the standard therapeutic use of phosphorus in the last decades have been directed primarily to the skeletal system. The most striking manifestation of chronic phosphorus poisoning, jaw necrosis, is the point of departure of experimental investigation. Wegner obtained in rabbits after a five to ten weeks residence in phosphorus containing air in imitation of this condition, a periostitis of the jaw with bony deposits on the alveolar border which went on to necrosis. From these investigations it was further yielded that continuous small doses of phosphorus could act as a formative stimulus on the bones and that the spongiosa was widely replaced by compacta. Kassowitz thereon tested phosphorus clinically in rickets and his recommendation still has value today. This has not been shaken by the fact that today irradiated ergosterin and no longer the great carrier of light (phosphorus) is the method of choice. From the findings of Kassowitz it may be stressed that with continuous and increasing doses of phosphorus a rarifying osteitis in the compacta, a marked growth of vascular rich cartilage and finally a melting down of bony inflammatory processes in the periosteum were found which he designated as like rickets.

In more recent times the role of phosphorus in the process of bone building has been more exactly studied in animals by Otsuki. In artificial fractures the resorption and new formation processes require more time than usual under small doses of phosphorus. But thereby was the resorption of old bone still more strongly delayed than the new formation so that a thickened bulwark of bone was the result of this rebuilding. Likewise in growing bones the depression of normal resorption predominated over the depression of new formation so that a broader and thicker layer of bone was the end effect. In spite of the damaging influence in the process of bone formation, the result was an excess of new bony tissue. This is also compatible with the findings of Wegner and Kassowitz.

In chronic poisoning of animals with phosphorus, the calcium and the phosphorus content of the bones increase considerably. Bernhardt and Rabe demonstrate a distinct influence of phosphorus on mineral metabolism and the formation of bone. Trisdall found the phosphorus content of the serum remaining at the same height during growth; with the conclusion of growth it rapidly fell and stayed at this level until death, but in a demand upon calcium metabolism, as in bone fracture, the growth level was again reached or even surpassed. The investigations of F. Sauerbruch and G. Hotz in patients with osteomalacia reveled that by the administration of phosphorus the organism gained the capacity to utilize calcium and also to retain and deposit it.

According to all this one may ascribe to phosphorus an influence on calcium metabolism in the sense of an activation and increased retention. It is worthy of note that even Wenger demonstrated a favorable influence on bone formation with phosphites as well as through unoxidized phosphorus itself. The close connection of phosphates to calcium economy has been mentioned in speaking of calcium. If one reviews the bone effects of phosphorus, the phosphites and phosphated together than the distance between the pure phosphorus and its various stages of oxidation diminishes in pharmacologic respects though at first it seemed to exist. Certainly it is not immaterial whether phosphorus, phosphites or phosphates are administered, but if we view the matter from various angles, it is seen that the difference lies not in the nature but in the intensity. Actually before the vigantol era, on account of the apparent danger of phosphorus, one had come to recommend phosphates in rickets and osteomalacia. That this phosphorus and phosphate therapy follows definitely the simile rule need not be stressed after the above discussion. In homoeopathy it has constantly been calcium phosphate which has been the most frequently used preparation in rickets and in bone therapy in general.

OTHER ORGAN ACTIONS

A certain similarity with the action on the bony tissue can be perceived in the action on other tissues. The end state of phosphorus poisoning in the form of the so-called fatty degeneration of the liver, the kidneys, the cells of the gastro- intestinal tract, the heart, the diaphragm, the skeletal muscle, and especially the vessel endothelium is well known. But if one follows the process more exactly, then from the prolonged action of small doses always an excitation of function occurs or an increased formation of tissue proceeds simultaneously. Even Harnack has perceived the new cell formation as minor grade action of the same poison whose stronger action effects death of the cells.

The cell action of phosphorus is best studied on the liver. At first the glycogen diminishes as do the cell proteids; the liver cells contract and show fatty degeneration. But according to the investigations of Opel, at the same time a new formation of young cells occurs. With stronger influence of phosphorus, the substitution by growing connective tissue or the epithelium of the biliary passages seems to gain preponderance. The situation of the kidney elements seems to be entirely the same.

It is worth of remark that also in the liver and heart, the calcium and phosphorus content increases in acute and still more in chronic phosphorus poisoning, while a marked decrease of calcium content and increase in total phosphorus has been found in skeletal muscle.

The well-known appearance of icterus in phosphorus poisoning has been traced to the finest biliary passage by the investigations of Stadelmann and Eppinger. Here also goes a state of increased secretion with increased amounts of biliary pigments, then apparently a stasis and destruction in the smallest biliary capillaries, a rupture of the capillaries with entrance of the bile into the lymphatic passages.

Here it may be remarked that phosphorus can be indicated in weakness of the heart muscle, nephritides and inflammatory liver affections. But in what form? That is the question in which the similarity of the structural end-results leaves us in the lurch. Here we must still consider the influence on the vascular endothelium and the reduction of the capacity for coagulation by phosphorus. Hemorrhages of all types can be further indications for the choice of phosphorus; also for, example, hemorrhagic nephritis. Similarly, an icterus increase the indications for phosphorus in pneumonia. Such supplementary structural indications, however, usually do not satisfy us but first the functional and subjective symptoms as they have been obtained from provings on the healthy give us exact differential characteristics.

METABOLIC ACTIONS

The actions of phosphorus on metabolism, particularly on carbohydrate and fat, have been studied primarily on the liver, obviously, because the liver is the favored site of attack for phosphorus. In investigation of the fat metabolism one proceeds from the fatty degeneration of the liver and other organs. The view that in phosphorus poisoning an increased formation of fat occurs from protein destruction can easily be shown to be erroneous. To the contrary, animal investigation shows rather an increase in fat substitution, naturally not in the hunger stage, but to an increased degree when sufficient amounts of carbohydrates are introduced.

Through abundant administration of carbohydrates the appearance of fatty liver can be prevented in phosphorus poisoning in spite of the presence of fat depots. This signifies that fats burn only in the flame of carbohydrates, as it has been strikingly expressed.

The fatty infiltration of the liver is indeed a substitution of used carbohydrates and proteins and one may perceive with Rosenfeld that it is the last attempt at a defense against an impending damage to the protoplasm, naturally a defective substitution for the cell material being destroyed. The enrichment in ether soluble constituents (as phosphatides, cholestrein, etc.) particularly in the liver, less strongly in the heart and kidneys, in phosphorus poisoning is recognized as fatty infiltration through a series of investigations. In any case the wandering of fat in these organs from the fat depots of the body (in case such are present) has been demonstrated (through proof of the infiltration of a foreign type of fat). For the development of a fatty degenerative infiltration of the organ through transport from the depot also speaks the fact that the fat that the fat content of the blood is increased in phosphorus poisoning.

But the fatty degeneration of organ cells rests not exclusively upon fatty infiltration because in actuality the fat content is often not found increased. Much more it is concerned only with a visibility (perhaps coagulation?) of fat in the decomposition of cells, so-called fat phanerosis.

An increase of protein destruction through phosphorus is frequently demonstrated in animal experiments as well as in man through increased nitrogen excretion in the urine. But it seems that this increased protein destruction appears only with a fat and carbohydrate deficiency, also after utilization of this burning material. In general, the results of animal investigation refer to the starved animal. Moreover, Retting succeeded in avoiding the destruction of protein entirely or approximately through administration of larger amounts of carbohydrate.

Otto Leeser
Otto Leeser 1888 – 1964 MD, PHd was a German Jewish homeopath who had to leave Germany due to Nazi persecution during World War II, and he escaped to England via Holland.
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,