On the other side, Unna explains the drying effect of sulphur powder through enrichment of the epithelial cells with sulphur which would be considered better as the physiologic process of cornification. It is possible that sulphur applied from without by its transformation to H2S perhaps converts SH groups in the diseased epidermis into sulphide groups (through deprivation) so that the cystein form, pathologic for the surface layers of epithelium, would be transformed into the physiologic cystin form. Kapitowaski, employing pure sulphur in the form of milk of sulphur ointment, found a corresponding result also on healthy human skin, namely proliferative processes in the form of increased cornification and vascular growth. These processes also correspond to a proving on the healthy with the external use of sulphur. Thy also agree with the skin alterations effected through the long-continued internal use of sulphur. The drying, keratoplastic action of exogenous sulphur was considered as a reduction by the older P.G. Unna. This contradicts the above mentioned conception of of increased cystin formation, for this represents an oxidation. The keratoplastic action of small doses should act by drying first on the horny layer, then the action of the vessels is added, the end-result consisting in a narrowing and drying out of the capillaries. In the sense of a palliative contrarium therapy, the external application would be indicated in moist forms of disease. The acute dermatoses and acute eczemas, however, according to Paul Unna, are exactly a contra-indication for sulphur, while the parakeratotic diseases as psoriasis, parapsoriasis, seborrheic eczema, pityriasis rosea, should also be improved through the external application of sulphur. Naturally, a very dry skin should represent a contra-indication for sulphur because, by it painful itching and fissuring would be increased.
The keratolytic effect on the horn cells with the stronger development of H2S represents the destructive fraction of the effect curve of sulphur on the skin. Iwan Bloch, a pupil of P.G.Unna, states: Accordingly we are confronted by the fact clinically proven with sulphur that small doses can exert a reversed effect on protein substances as compared to large doses of the same substance. Therein one might see an example for the partial recognition of that which has found expression in the so-called Arndt-Schulz law.
The keratolytic end-effect of sulphur is used particularly in scabies where the epidermis and the parasite are to be affected at the same time. But there is also to be considered here another action component of sulphur which makes it especially suitable, because not every keratolytic agent is an itch remedy. Probably the disinfection power is due to the SO2 formed by oxidation. According to Golodetz any action sulphur on the skin should be considered only as through H2S; according to Heubner H2S cannot appear in reaction with healthy and injured surfaces of the epidermis; his theoretic conceptions cannot be confirmed, however, by experience as those of Kapitowsky; Maliva particularly has proven the penetration of sulphur in the form of H2S through the skin by blackening of subcutaneous deposits of bismuth in animal experiments. For the keratolytic action, besides the marked formation of H2S, the alkaline reaction is presumed as a prerequisite. The alkalescence serves at the same time as a path breaker for increased action upon the skin. In agreement with this stands the fact that Menschel considers absorbability in the epidermis primarily dependent upon alkali content and moreover Gans has shown that the effectiveness of sulphur agents is increased through raising the grade of alkalescence of the uncornified layer. According to Gans, in fresh inflammatory moist skin eczema, an alteration in the sense of an alkalosis should be present while in dry eczema and in psoriasis a shifting towards the acid side should exist. This difference in H-ion concentrations explains many individual manifestations in respect to sulphur action which up to now have been held as idiosyncrasies to sulphur. Gans believes because of the marked alkalescence in the exudative forms of eczema there is a stronger action, Paul Unna holding that it is exactly in these forms that sulphur is contradicted, obviously because of the stronger action. Unna holding that it is exactly in these forms that sulphur is contradicted, obviously because of the stronger action. Unna considers exactly the dry processes as most suitable for sulphur therapy, in which, according to Unna and Golodetz, the tissue reacts acid.
After all we must assume that the use or damage of an external sulphur medication is not dependent alone on the dose of pure sulphur introduced but also upon the state of the morbidly altered skin surface, in particular upon a pathologic cystin supply and on alkaline reaction which probably conditions an accelerated and increased formation of effective H2S. So would many contradictions in dermatologic reports and experiments be solved.
Similar reflections hold for the usual effect on the skin of sulphur given internally. Moreover, in order to understand the single effects, one must take into consideration the function of the skin organ directed towards within as well as without. Such a possibility of effect has been studied more closely by E. F. Muller and Delbanco. They used sodium thiosulphate for therapeutic purposes. According to Bauer this is an intermediate transformation product of sulphur. An arsenic or salvarsan erythema can be made to disappear through the intravenous injection of it. Simultaneously the arsenic, which had previously disappeared from the blood and in the excretions (urine and feces), appears again. The appearance of the erythema is conceived as limited skin metabolic process for the substance concerned. Sulphur removes this store in the skin function and directs it toward the blood. Sodium thiosulphate is also given as an antidote in acute heavy metal poisonings. This should also explain the mobilization of heavy metal depots (for example, mercury) in the skin through sulphur baths. This mobilizing influence of sulphur, introduced by metals through an increase in function of the skin, perhaps has its other side in the participation of sulphur in the compound state with heavy metals. Indeed it is not improbable that the metal is joined to the SH group of the protein and that its (according to different organ or tissue affinity) toxic action consists primarily in the exclusion of the physiologic role of this sulphur group in cell protein. One must not leave out of consideration the particular chemical connections of heavy metals to sulphur which also have a geochemical significance.
A detoxifying role of sulphur in the skin has also been made plausible through the so-called detoxin. On this extract from the skin rests the strong antitoxic action of sulphur-containing organic compounds.
The activation of chemicals and irritant poisons in the skin, just as in the total metabolism, includes a metabolic promotion in the first phase of sulphur action. Such an action only apparently contradicts the experimental findings with the long- continued sulphur medication. They are in agreement with the findings in acute influences of single parenteral doses.
The stages of sulphur action can be easily followed in the skin. At first the metabolism in the skin is promoted and the activity of the sebaceous glands is also increased. The picture of seborrhoea oleosa is however, less characteristic for sulphur than for the related selenium. With sulphur there soon occur inflammatory alterations in the capillaries and the sebaceous glands (dermatitis, acne). With longer continued doses the proliferation of vessels is promoted and the transformation to keratin, and cornification, is accelerated. This keratoplastic effect leads to dirty, scaly, dry, hard, fissured skin which characterizes the depressed skin metabolism of sulphur patients. Here to some extent the limit of excretion of endogenous and exogenous substances adapted to the skin is obtained; the sulphur disturbance is deep, has become constitutional The keratolytic effect, on the contrary, is observed only accurately from massive, usually exogenous, applications.
INTERNAL SULPHUR THERAPY
Only since industry has created colloidal sulphur preparations for injection has the internal use of sulphur again come into popularity. For skin diseases the old practice of local applications of sulphur still prevails; the internal use is rare. But the field of chronic diseases, particularly joint diseases, is opened for the internal use of sulphur, naturally in the understanding of non-specific irritant therapy. A constitutional sulphur treatment is still another step.
Also at present the complete neglect of internal sulphur therapy has yielded to natural sulphur waters, as baths and drink regimes, a modest and, scientifically, ever debatable position.
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,