Nothing stands in the way of the conception of a fundamental association in the type of actions from phosphorus over phosphites to phosphates; only the speed and severity of the effect and thereby the toxicity is connected to the step of oxidation.
The toxic actions of phosphates can be perceived as calcium-ion deficiency or potassium or vagus predominance on the striated and smooth muscle, and this without tracing the entire action of phosphate back to this de-ionization or synergism. The toxic action on the voluntary muscle and the heart, as with potassium, consists of a reduction of tonus, while the physiologic potassium as the phosphate is a pre-condition for muscle function; apparently it supplements in the the muscle as do calcium and phosphate in the bones. The toxic action of phosphate on the heart leads to slowing of the pulse and to stand-still in diastole, as does potassium. But with both, an improvement in the heart muscle can be obtained after mechanical or toxic damages. On smooth muscle, phosphates as well as potassium acts tonus-increasing. The poisonous action of phosphates expresses itself more distinctly than with potassium in the diarrhea. A significant increase in tonus and the pendal movements has been proven by Starkenstein on the isolated intestine. We shall discover this diarrhea again in the picture of phosphoric acid.
PHOSPHORUS AND PHOSPHATES IN METABOLISM
The influence on cellular metabolism by phosphorus, in particular on gas exchange, has been the subject of many investigations. The results are often contradictory. According to Lusk and Hirz, there seems at first to be an increase in metabolic conversion and gas exchange and then shortly before death a decrease in the action of phosphorus. It arose even more distinctly from the investigations of Nishura: phosphorus in small doses promoted cell respiration. 1/100 mg. of phosphorus injected subcutaneously into rats regularly produced a persistent increase of O2 use, whereby the weight slightly increased. The gas exchange was influenced for eight days after an injection. If the doses were increased, then a single injection of 1/10 mg. gave a persistent decrease of O2 use without a distinct influence on weight. Daily injections of 0.5 mg. for three days caused the O2 use to fall to 1/3 and the temperature to fall to 27 o C. Of particular importance is the fact that feeding thyroid substance reduces the consumption of O2 even with 1/1000 mg. of phosphorus, so that these animals seem at the same time sensitized to phosphorus effects by the administration of thyroid substance.
The gas exchange of phosphorus-poisoned animals was reduced about 20 per cent, the action beginning about twenty-four hours after the administration of phosphorus. Phosphates also promote cell respiration, and here too we have a parallelism between the action of phosphates and phosphorus. Surviving intestinal cells show an increase of respiratory effect even from the slight concentration of N/1000 primary and secondary natrium phosphate, while the optimum lies in a concentration of N/100-N/200, and with higher concentration consumption decreases. Likewise in other instances in organic life catalytic processes are favorably influenced through phosphorus salts. Bucher has already proven this for yeast fermentation and American investigators have shown that carbohydrate and fat formation increases in yeast cells under phosphates. Even for phosphorus a corresponding report is found in Hauser’s work in which a yeast- sugar mixture to which phosphorus was added showed initially a more rapid and stormily proceeding production of CO2 than under normal conditions.
CONNECTIONS TO ENDOCRINE GLANDS
Phosphorus has important connections to the thyroid and its function. In phosphorus-poisoned animals one found alterations in which the colloid was diminished or had disappeared, findings, which are also noted in Basedow goiters. On the cerebral ganglion cells the same histologic alterations were found as after thyroidectomy. The iodine and phosphorus rations stand inverse in the thyroid. The iodine content increases with the decrease in phosphorus and vice versa. Phosphates act weaker than elementary phosphorus. Alb. Kocher has recommended natr. phosphoricum in doses of 2-12 G. daily in Basedow. In pregnancy a fall in the iodine content to 1/30 normal is observed and the phosphorus triples. In a Basedow one has seen a similar fall of the iodine and the increase of phosphorus content to double. Under the use of thyroidin an excretion of phosphoric acid occurred and phosphorus content to double. Under the use
of thyroidin an excretion of phosphoric acid occurred and phosphorus treatment caused an enrichment of the thyroid in iodine. The sensitization for phosphorus action by the administration of thyroid preparations has already been mentioned. The reciprocal relation between iodine and phosphorus should not be conceived one-sidedly as an antagonism nor as a synergism.
On the adrenals Neubauer and Porges showed that, through phosphorus poisoning, the chromate discoloration of the medulla is removed and the formation of adrenalin depressed. They trace the lowering of blood pressure in phosphorus poisoning back to the adrenal damage instead of to the cardiac damage as is so frequently done. They also bring the disturbances of carbohydrate metabolism into connection with the functional failure of the adrenals since in extirpation of the adrenals the glycogen disappears and the blood sugar content falls. One has also prevented the disappearance of glycogen in phosphorus poisoning through the injection of adrenalin. Perhaps in analogy with the biphasic action in other organs with small doses of phosphorus there may be a stimulation of adrenal function and also in secretion of adrenalin. Vollmer described after the injection of adrenalin a biphasic action on the calcium and phosphorus content of the serum. The calcium content at first increases and then decreases and the phosphate content exactly the reverse: decreases and then increases.
The influences known up to the present of phosphorus on the endocrine system are not sufficient to indicate its constitutional peculiarity more than a general trend, chiefly in the direction of a Basedowoid sensitization. The influence on metabolism through phosphorus may be brought into good accord with this.
NERVOUS SYSTEM
The toxic manifestations on the nervous system are often perceived as dependent upon the alterations in the vascular system. The great abundance of phosphatides (lecithin) in the central nervous system makes it probable from the start that the physiologic role of phosphorus likewise corresponds pathogenically and therapeutically. In old times phosphorus was considered particularly as an important agent in maladies of the motor and sensory nerves and also in homoeopathy (for example
in the monograph of Sorge this trend of action is always stressed).
From newer studies it has been shown that the phosphatide content of the brain is altered in progressive paralysis. It had been shown even earlier from the derivation of phosphoric acid in brain emulsions that phosphorus was important in the brain and today it is more than probable that disturbances in cholesterin-phosphatide metabolism lead to functional alterations of the brain. It can also be proven that in the retina of the frog, light stimuli discharge phosphoric acid. In peripheral nerves the nitrogen consumption on stimulation is markedly reduced through the addition of phosphatides. In the very lively metabolism of the central nervous system, phosphorus compounds must have even a greater significance. In mental diseases and experiences which are associated with general exhaustion occurs a marked destruction of the organic phosphorus compounds of the central nervous system and the excretion of phosphates is increased. Outside of the inorganic phosphates about 1 per cent of the total phosphate is excreted as organic compounds, and, when the oxidation processes are weaker in mental fatigue, the percentage of organic phosphates increases in the urine.
Naturally the organic alterations in the central nervous system are slight in acute and a chronic phosphorus poisoning. Only occasionally paralyses are observed (in contrast to arsenic), once under phosphorus therapy a paralyses of the auditory. The ordinary findings in the central nervous system are apparently a result of capillary bleeding and fatty deposits in the ganglion cells and also degeneration of the columns of Goll and Burdach. Findings of myelitis and pigment deposit are doubtful.
Probably the severe toxic actions are ended by some other occurrence before a destruction of the structure of the nervous system can occur. The severe psychic symptoms which are occasionally observed in phosphorus poisoning and other milder symptoms can be accepted as probable.
The previously mentioned mass investigations with phosphates make it very plausible that not only the muscle metabolism but also the nervous system participates similarly in an increase of performance. In larger series of investigations phosphoric acid produces mental invigoration and joy of work. With longer use the frame of mind of the psychically depressed is favorably influenced. In the clinical studies of Staub with di-sodium phosphate in cardiac patients, the patients in many instances reported themselves rapidly relieved, one patient as though he had been freed of something. Similar actions are observed with tonophosphan in the cyclothymic depression states. Likewise involuntary psychic results are observed. Many patients under the use of phosphates complain of much dreaming and disturbances of sleep, others of wandering pains in the extremities, restlessness and hypersensitivity to noise. It is to be observed that these symptoms appear first under large doses of phosphates. In the first few days of a phosphorus poisoning a euphoria is noted.
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,