UNDERSTANDING MANGANUM ACETICUM

THROUGH
HAHNEMANN’S MATERIA MEDICA PURA
DR. ANJU JETHANI M.D. (HOM.)
Sr. Medical Officer, Medical Center, High Court of Delhi

Sr. Lecturer, Department of Organon of Medicine,

Nehru Homoeopathic Medical College, New Delhi
E-mail: dranjujethani@gmail.com
#9818456536

ABSTRACT: A much neglected work of Hahnemann, Materia Medica

Pura, contains wonderful pearls of clinical wisdom which can be used
by every homoeopathic practitioner for use in clinical practice. The
following article intends to highlight the above said point through
study of a lesser known medicine, Manganum aceticum.

INTRODUCTION

Before I begin the discussion on the understanding of lesser known

medicine, ‘Manganum aceticum’ (Acetate of Manganese) from the
magnum opus work of Master Hahnemann ‘Materia Medica Pura’, let
me delve upon a very basic, yet misunderstood concept. In the modern
fast paced era where newer and newer things are coming up and
replacing the ‘so-called older one’, what is the need to study a book on
Materia Medica that is as old as about 200 years? What is the need to
put efforts in reading and understanding such a literature? In other
words, what is lacking in modern Materia Medicas that necessitates
finer study of such work as Materia Medica Pura.

The first and foremost reason for the study of ‘Materia Medica Pura’ is
that it is a genuine book with no scope of ‘theoretic medicine’ as
Hahnemann has stated in §1 footnote. The second important aspect is
that ‘Materia Medica Pura’ is an open-ended book which provides for
unending avenues for prescribing. Let me discuss this point in further
details. With the changing patterns of diseases, the study of modern
practice of medicine is focusing less and less upon the disease
diagnosis and more and more emphasis is being laid on diagnosis of
syndromes. Materia Medica Pura is a compilation of varied syndromes,
some of which have been recognized and some unrecognized. The
varying permutation of symptoms produced in each drug enables us to
predict the syndromes that have not yet taken shape but may appear in
the future generation to come. It is this flexibility of approach that has
made this so-called old literature the REAL LITERATURE OF
TOMMORROW.

Now, coming to the topic of our concern i.e. study of Manganum

aceticum from Hahnemann’s Materia Medica Pura. Before proceeding
to undertake this, let us beforehand understand the physiological
effects, Modern medical use and toxicological manifestations of
Manganese.

 PHYSIOLOGICAL EFFECTS:

Manganese is a component of the antioxidant enzyme Manganese

Superoxide Dismutase. These can neutralize free radicals & may reduce
or even help prevent some of the damage they cause.

EFFECT ON BONES: Manganese is an essential nutrient involved in

the formation of bone and in amino acid, cholesterol, and carbohydrate
metabolism. Manganese metallo-enzymes include arginase, glutamine
synthetase, phosphoenolpyruvate decarboxylase, manganese
superoxide dismutase, Glycosyltransferases and xylosyltransferases,
which are important in proteoglycan synthesis and thus bone
formation.

EFFECT ON GASTRIC SECRETIONS: Stomach acid levels interact

synergistically with iron and manganese, whereby the absorption of
both minerals is enhanced by higher HCl acid levels, and likewise, an
increase in iron or manganese will generally - but not always - result in
raised stomach acid levels.

ROLE IN FERTILITY: Manganese is called the "maternal mineral"

because manganese deficiency in females causes a reduced maternal
caring for her young. Enzymes involved in cholesterol synthesis are
manganese dependent, so a manganese deficiency can decrease sex
drive.

 MODERN MEDICAL USE:

1. On account of its significant action on bones, manganese is

utilized in treatment of osteoporosis and osteoarthrosis.
 2. It is one of the components of the multivitamin drugs
because they are important in the utilization of Vitamin B1.

TOXICOLOGICAL MANIFESTATIONS:

High levels of manganese are toxic to babies because they lack the
blood-brain barrier that develops later in childhood. Manganese
overdose is associated with brain damage leading to violent behavior.
Further, Manganese administration induces the increased production of
Dopamine Sulfate which is known to be a chemical mediator in
seizures.1 Despite its important functional roles, manganese at
excessively high concentrations may become neurotoxic for humans
and other mammalian animals. For example, occupational exposure to
manganese dust among miners has been shown to cause neurological
symptoms resembling Parkinsonism.

SALIENT FEATURES OF MANGANUM ACETICUM

FROM THE STUDY OF MATERIA MEDICA PURA

DEPTH OF ACTION:

Manganum aceticum is a deep acting medicine as can be deciphered

from MMP’s introduction part of Manganum acet. whereby
Hahnemann has clearly stated that :

‘Even the decillion fold dilution would be too powerful for most of the
cases, so that only a small portion of a drop of it is given for a dose. It
will be perceived from the following symptoms how extremely
powerful this medicine is, and if, as I wish, it shall be further proved by
other accurate observers, we shall know how indispensable it is for
many of the worst chronic ailments, for which other medicines are not
so perfectly homoeopathically suitable………..It can be perceived from
the symptoms that it is an extremely powerful medicine. In small doses
it acts for several weeks’.

SPHERE OF ACTION:

Bones and Periosteum Teeth Larynx

& trachea

1Montgomery, E.B. (1995) Heavy metals and the etiology of Parkinson's disease and other
movement disorders. Toxicology 97, 3-9
Hahnemann has emphasized that ‘It will be found to be very
efficacious, especially in some intolerable pains in the periosteum &
joints , diminution of the senses , and diseases of the larynx and trachea.

The following symptoms of MANGANUM ACETICUM in MMP

highlight the efficacy of said drug on:

(i). Bones and Periosteum:

Symptom no 26: In the morning, in bed, an external headache

consisting of fine needle-pricks on the right occipital bone, which
extended to the fifth cervical vertebra, and was aggravated for turning
the neck, for an hour and a half. [We.]

Symptom no 64: In the internal bone of the ear a digging, at night. [ Gss.]

Symptom no 94: In the left upper jaw a pain as after a blow or knock (aft.
2 h.). [Hbg. ]

Symptom no 183: In the right clavicle a gnawing & digging (aft. 36 h.)
[Gss. ]
Symptom no 225: In the lower end of the shaft of the humerus a gnawing
pain, at night (aft. 12 h.). [Gss. ]

Symptom no. 253: In the ischium pain when sitting , a persistent stitch.

Symptom no. 267: Drawing and sore pain in the left tibia, when
standing, as if it were broken; this pain goes off when sitting.[Fz.]

Symptom no. 268: Drawing tearing pain on the right tibia, when sitting ,
which went off on rising up, but returned when at rest.[Ar.]

Symptom no. 287: Nocturnal digging pains in several bones.

(ii) Diseases of Larynx and Trachea:

Symptom no 107: When swallowing, each time an obtuse stitch from

both sides of the larynx- each time two stitches, one from either side-
also when swallowing food or drink, which shooting went each time
into the left ear.

Symptom no 178: In the morning on rising from bed, rough throat with
hoarse, wooden voice. [ L. Rkt.].
Symptom no 179: In the morning rough voice, without sensation, in the
throat; the roughness goes off when smoking tobacco. [ Fz. ]

Symptom no 180: In the open air he immediately gets dry throat & rough
voice, with cutting aching in the abdomen & nausea in the chest. [ Fz. ]

Symptom no 204: Irritation to cough: he seeks to detach by coughing

something adherent in the larynx, but only a little mucus is brought up
with difficulty & rather by a certain sharp expiratory movement of the
chest than by actual cough. [ Stf. ]

(iii). Toothache:

The effect of Manganum acet. in toothache appears in symptom no. 89-

93, 97, 99

CHIEF SENSATIONS OF MANGANUM ACETICUM:

(1) SHOOTING NATURE OF PAIN:

Symptom no 16: When walking, even in the room, a shooting shock

over the right eye.

Symptom no 67: Every time he speaks an obtuse shooting pain in the

ear.

Symptom no 69:A scrapping shooting sensation in the region of the

membrana tympani. [Hbg. ]

Symptom no 95: When laughing a violent twitching, shooting pain

from the right side of the lower jaw to the right temple (aft. 6 d.)

Symptom no 190: Sometimes on expiration an upward drawing

shooting pain in the chest.

Symptom no 221:An out-boring shooting pain on the inner side of the

right upper arm, for a quarter of an hour. [Ar. ]

Symptom no 235:Drawing shooting pain on the back of the right

forearm. [Ar. ]
SHOOTING NATURE OF PAIN IN THE LAST APPEARING
SYMPTOMS:

Symptom no 32: On walking quickly a shock, like violent shooting in

the head above the right eye (after 20 d )

Symptom no 189: on expiration, shooting in the upper part of the

chest.(after 10 d.)

(2) EXTENSION OF THE PAIN :

*TO THE INNER EAR:

Symptom no 62: A horrible pain the teeth leaves her suddenly & settles
in the internal ear. [Stf]

Symptom no 65: In the forenoon especially, when walking quickly, a

violent shooting drawing pain from the forehead into the ear, which
ended in the memrana tympani as a persistent out-darting stitch as long
as he continued to walk; after standing still this pain gradually subsided
(aft. 48 h ).

Symptom no 66: Every time he laughs a violent drawing shooting pain

from the stomach up into the ear in the region of the memrana tympani.

Symptom no 91: Toothache of a horrible kind :it darts suddenly into

two somewhat decayed molars opposite to one another-more in the
upper-where the pain is then indescribable, thence it goes occasionally
into the arm, the zygoma, the throat or the ear,& again returns to the
teeth, with complete prostration of the strength- he can scarcely walk,
he must lie down, with extraordinary internal uneasiness & oppression;
by a few mouthfuls of coffee the pain when at its height, was
momentarily removed, but after a minute recurred with all its former
violence- with rather dialated pupils; it was somewhat elastic, or by
laying the forehead on the table, but it was much aggravated by sitting
upright. [Stf. ]

Symptom no 107: When swallowing, each time an obtuse stitch from

both sides of the larynx- each time two stitches, one from either side-
also when swallowing food or drink, which shooting went shooting
went each time into the left ear
*TO OTHER PARTS:

Symptom no 22: Aching digging pain in the temples which extends

towards the eyes & forehead, is not removed by external pressure with
the hands, goes off on stooping forwards, but returns on sitting upright
& bending backwards:.(aft. 4 h.) [Trn.]

Symptom no 24: A shooting external headache that was persistent in

the room goes off in the open air, & he feels himself free from his other
sufferings & well. [Fz.]

Symptom no 26:In the morning,in bed, an external headache consisting

of fine needle pricks on the right occipital bone, which extended to the
fifth cervical vertebra, & was aggravated by turning the neck, for an
hour and a half. [We.]

Symptom no 90: In the molar on the right side a (drawing) pain, which
often goes off suddenly, & gives place to (drawing) pains in other parts,
on the face, neck, & right arm. [Stf.]

Symptom no 97:A horrible pain in the teeth leaves them suddenly &
goes into the cervical muscles; the neck feels swollen & stiff. [ Stf.]

Symptom no 218: Drawing & tearing from the shoulder down through
the whole arm.

Symptom no 231:A horrible toothache suddenly goes off, & the pain
goes into the arm , which then pains as if paralyzed.[ Stf.]

Symptom no 274: Swelling & inflammation of the left outer & inner
ankle; shooting from the outer ankle up into the leg, when walking: per
se there was only occasional shooting in it.

(3) BRUISED SENSATION AS AFTER BLOWS.

Symptom no 94: In the left upper jaw a pain as after a blow or knock
(aft. 2 h). [Hbg. ]

Symptom no136: Under the last ribs bruised pain.

Symptom no 196: A dull pain in the sternum, as after a blow, in the

morning .[We. ]
Symptom no 245: In the proximal joint of the left index, pain as if he
had had a blow on it- a paralytic pain, most felt when at rest . (aft I h.)
[Gss.]

Symptom no 257: Bruised pain transversely across the thigh.

(4) THIRSTLESSNESS WITH DRYNESS:

Symptom no 104: In the morning, dry throat without thirst. [ Fz.]

Symptom no 112: In the morning on waking, bitter taste in the mouth,

with dry lips, without thirst (aft. 6 h.)

Symptom no 123: Complete absence of thirst, too little desire to drink,

for many days.

Symptom no 306: Late in evening, rigor & coldness of feet- the right leg
was cold up to the knee-without thirst or subsequent heat.

Symptom no 316: Sudden flying heat & redness of the face, especially
when standing, without thirst- soon passing off.(aft.3/4h.) [ Lr]

(5) VIVID DREAMS:

Symptom no 291: After midnight ( about 3 a.m. ), in bed, he dreamt that

he was awake & with his doctor, as in perfect consciousness, & he could
afterwards recall every word of the conversation, just as though all have
occurred to him when awake.( after a few hours)

Symptom no 292: Very vivid, anxious dreams, as if everything occurred

when he was awake, remembered in every detail; on waking he felt
strong

Symptom no 294: Vivid dreams with rapid changes of the subjects, with
frequent waking in full consciousness of what he had dreamt but in the
morning he has but a dim recollection of his dreams. [Fz.]

Symptom no 296: All night confused & sometimes even anxious, very
vivid dreams .[Fz. ]

Symptom no 298: Vivid, anxious, frightful dreams. [ Lr.]

Symptom no 299: All night, without cessation, very vivid but confused
dreams, jumping from one place & from one subject to another. [ L.Rkt.]

Symptom no 301: He dreamt very vividly of two persons who were to

come the next day, & who did actually come. [ Hbg. ]

Symptom no 302: Vivid dream of reconciliation. [ Lr.]

CHIEF MODALITIES:

*AGGRAVATED IN THE OPEN AIR:

Symptom no 5: Every time he walks out in the open air, slow drawing
stitches-more rarely shooting aching- in the sinciput (after being some
time in the room this pain in the head ceased).

Symptom no 6: Contractive shooting pain in the whole sinciput,now

here, now there, especially in the temple-chiefly in the open air

Symptom no 68: From time to time sharp aching in the right ear, when
walking in the open air, as if earache would come on, in the
evening.[Hnt.]

Symptom no 70: Cramp like, aching pain behind the left ear, which
went off on touching, when walking in the open air (aft 34 h.).[ Lr.]

Symptom no 180: In the open air he immediately gets dry throat &
rough voice with cutting aching in the abdomen & nausea in the chest.
[Fz. ]

Symptom no 266: When walking in the open air, a peculiar tensive

feeling of the left lower extremity as if it were stiff (aft 13 h.). [ Lr.]

Symptom no 305: Rigor & coldness when walking in the open air-in
moderately warm air; when walking quickly the chilliness was allayed,
but the coldness of hands & feet remained until he came into the room
where they became warm.

*AGGRAVATED BY TOUCH:

Symptom no 25: Tearings & tearing jerks on the occiput externally, for
three successive afternoons; at other times this part was the seat of
simple pain, per se, but was more painful when touched.
Symptom no 84: In the angle of the right lip a pimple, which on moving
the mouth & on touching it has a tensive & eroding pricking pain.

Symptom no 93: The tooth is painfully sore (as if ulcerated) to the

slightest touch ,less so when not touched. [ Stf.]

Symptom no 134:Aching in the scrobuculus cordis & on the chest,

aggravated by touch. [Fz. ]

Symptom no 217: First in the shoulder joint , then in the elbow-joint,

sensation like an internal clucking, but on both joints externally , when
touched, an intolerable pain like a boil: he dared not grasp it.

*AMELIORATED BY LYING DOWN:

Symptom no 210: Deep cough, without expectoration, all day, which

ceased when lying down returned the following day with tenacious
mucus expectoration, & pain as of a concussion in the scrobiculus cordis
& chest, but went off quickly at noon.[ L.Rkt. ]

Symptom no 279: On rising up from bed, in the evening, a severe

burning over the skin of the whole body, which went off on lying down
again in bed.(aft 8 h.)

Symptom no 91: Toothache of a horrible kind :it darts suddenly into

two somewhat decayed molars opposite to one another-more in the
upper-where the pain is then indescribable, thence it goes occasionally
into the arm, the zygoma, the throat or the ear,& again returns to the
teeth, with complete prostration of the strength- he can scarcely walk,
he must lie down, with extraordinary internal uneasiness & oppression;
by a few mouthfuls of coffee the pain when at its height, was
momentarily removed, but after a minute recurred with all its former
violence- with rather dialated pupils; it was somewhat elastic, or by
laying the forehead on the table, but it was much aggravated by sitting
upright. [Stf. ]

SYNDROMES OF DISEASES FOUND IN PATHOGENESIS OF

MANGANUM ACETICUM:

*CERVICAL SPONDYLOSIS:
 Symptom no 26: In the morning, in bed, an external headache
consisting of fine needle-pricks on the right occipital bone, which
extended to the fifth cervical vertebra

Symptom no 98: In the evening a cramp-like pain in the muscles of the

nape, on moving them [Fz. ]

Symptom no 99: Drawing tensive stiffness of the nape,which alternates

with toothache[Stf. ]

Symptom no100:A stiffness of the nape [ L. Rkt.]

Symptom no 101: At night a digging in the most internal part of the

cervical vertebra. [ Gss.]

*SINUSITIS:

Symptom no 17: Drawing pain in the occiput, the orbits & the forehead,
which later is aggravated by stooping & goes off by pressure with the
hand [Fz.]

Symptom no 20:Tearing in the left side of the forehead as if in the bone,

especially on moving the frontal muscles.[ Hnl. ]

Symptom no 22: Aching digging pain in the temples, which extends

towards the eyes & forehead,is not removed by external pressure with
the hand,goes off on stooping forwards,but returns on sitting upright &
bending backwards (after 4 hours) [Trn.]

Symptom no 39:On moving the eye inwards & upwards a sharp

pressure in the eyeballs.[Hnl.]

Symptom no 103:Dry scraping & scratching in the throat making him

hawk often.[Stf. ]

Symptom no 207: Morning cough with expectoration (after 21 hours)

[Hbg.]

*REFLUX OESOPHAGITIS:

Symptom no 116: Sourish,bitter dry sensation in the mouth & qualmish

warmth from the stomach up into the mouth, in the morning.(after 11
days.)
Symptom no 125: Sour, burning sensation, like heartburn, from the
stomach nearly into the mouth, in the evening( after several days)

Symptom no 126: In the morning on rising, sourish burning, sick

feeling from the stomach upto the mouth like heartburn.( after 9 days)

Symptom no 141: From the middle of the abdomen to the half of the
chest (the oesophagus)a rising up feeling, consisting of nausea,warmth
& contraction.

*OSTEOLYTIC LESIONS:

Symptom no 215: Tearing pain down the whole spine for six hours,
when at rest & when moving. [Ar. ]

Symptom no 225: In the lower end of the shaft of the humerus a

gnawing pain, at night. ( after 12 hours). [Gss.]

Symptom no 226: In the shaft of the humerus a digging about pain in

fits,at night when lying in bed on that side. [Ar.]

Symptom no 234: Tearing pain on the lower end of the radius of the left
forearm,as if in the bone, which not altered by anything for three
minutes. [Ar. ]

Symptom no 267: Drawing & sore pain in the left Tibia when standing,
as if it were broken; this pain goes off when sitting.[ Fz.]

Symptom no 268: Drawing tearing pain on the right Tibia, when sitting
which went off on rising up, but returned when at rest. [Ar. ]
Symptom no 269: (Sore) sensation on the right Tibia, as if it were
bruised.[ Fz.]

Symptom no 287: Nocturnal digging pains in several bones. [G.ss]

The above discussion aptly underscores the importance of going

through the Hahnemannian proving as laid down in his work Materia
Medica Pura as it contains valuable clinical tips for the benefit of
suffering humanity.