Charles D. F. (Charles Douglas Fergusson) Phillips.

Materia medica and therapeutics, inorganic substances; (Volume 2) online

. (page 16 of 40)
Online LibraryCharles D. F. (Charles Douglas Fergusson) PhillipsMateria medica and therapeutics, inorganic substances; (Volume 2) → online text (page 16 of 40)
Font size
QR-code for this ebook


inches of the anus, is affected, and there is much muco-purulent discharge.
For such cases Mr. Heath recommends an injection containing about 10
gr. of sulphate to the pint, a fourth part to be used at one time, and re-
tained for ten minutes: this has an excellent astringent effect, and should
be combined with the use of mercurial ointments locally, and iodides in-
ternally (Z/ancet, i., 1873).

Cancer. The arsenite of copper is said to be a valuable application
for cancerous sores. Mr. Taylor (Liverpool) used it with an equal part
of mucilage, and found it a good escharotic, disinfectant, and at the same



124 MATERIA MEDIC A AND THERAPEUTICS.

time sedative dressing (Lancet, ii., 1864) ; it has not, however, been much
used.

Skin Diseases. In parasitic cases, such as ringworm and scabies, the
sulphate of copper has been applied with success: in the former Dr. Graves
recommended a wash containing 10 gr. in the ounce, a strength which
may, with advantage, be doubled: an ointment containing a similar pro-
portion mixed with lard has cured scabies (Lancet, i., 1846). In ichthyo-
sis, this ointment has also been recommended by Mr. E. Wilson, and the
solid crystal is often used for verruca (wart) and molluscura.

Gonorrhoea Leucorrhcea Gleet. In these disorders an injection
containing sulphate of copper, 1 to 2 gr. in the ounce, is often a useful
alternative to injections of zinc or lead, or it may be combined especially
with the acetate of lead. Dewees and also Diday have shown the value
of cupric injections in such cases (Archives Gen., xviii., p. 385), and Dr.
P. Foster has more recently illustrated the same (Medical Times, ii.,
1873). In balanitis a copper lotion is useful.

jBubo, etc. Good results have been obtained after surgical evacuation
of a suppurating bubo, from injecting a weak solution of copper sulphate
into the cavity. M. Danielli found this quickly diminish the secretion,
which after simple opening is very apt to re-form (Bulletin de Therapeu-
tique, 1868). M. Diday recommended a strength of 3 gr. to the ounce.
The solid sulphate is a good application to syphilitic cracks, patches, and
ulceration about the mouth and tongue.

Hydrocele. As an injection for hydrocele, 2 to 8 parts of sulphate in
200 to 250 of water have been used with success. Dr. Pereira (Oporto)
states that twenty-one out of twenty-five cases were cured with this treat-
ment (Medical Times, i., 1861).

Caries Fistulous Tracts. Strong stimulating and astringent lotions
are sometimes of service in these conditions, especially after the carious
bone has been removed or the fistula divided. The "liquor Villati " has
been much used abroad in such cases without previous operation. It is
made with \ oz. of sulphate of copper and of zinc, and 1 oz. of lead sub-
acetate, dissolved in 7 oz. of vinegar; M. Notta and M. Xelaton have
used this with advantage, but it is painful, and should not be injected
more than two or three times in a week ( Union Medicale, 1866).

THERAPEUTICAL ACTION (INTERNAL). In small doses the salts of cop-
per exert a tonic influence upon the nervous system, and an astringent
effect on mucous membranes, while doses of 1 gr. and upward are emetic.
The salts in question clearly resemble in action those of zinc, but are
somewhat more irritant.

Chorea. Although preparations of copper are not now much used in
this affection, I can refer to some very good results from the sulphate in
my own experience, and especially in cases connected with taenia and
other intestinal worms. I think it well worthy of use in cases where there



COPPER. 125

is even a suspicion of their existence; it will aid their expulsion if pres-
ent, and in any case act as a good nervine tonic. I have seen permanent
good results from ^ gr. given three times daily, though sometimes this
dose needs to be gradually increased.

Hysteria. In some cases of hysteria, with general debility, shyness,
muscular twitching, etc., marked benefit may be derived from the same
treatment.

Epilepsy. It is probable that of the older cases called epilepsy, and
reported as cured by copper, a large proportion were hysterical, but Voisin
reports from the practice of Herpiri (Geneva) several illustrations of its
power to cure chronic and obstinate cases of true epilepsy. He generally
used the ammonio-sulphate alone, or alternately with zinc, for many
months; the cure continued permanent some years afterward (Bulletin
de Thbrapeutique, i., 1870). Halford made great use of copper combined
with quinine in this malady (Medical Times, i., 1858), but general experi-
ence is not in its favor. Charcot has published a case carefully treated
for three months with full doses of the ammonio-sulphate, but the con-
vulsive attacks were rather increased during its use (British Medical
Journal, i., 1875). I have given the sulphate and the acetate in varying
doses and for long periods in many cases, but have not seen benefit from
them in true epilepsy, although for epileptiform attacks dependent upon
intestinal worms, they have several times proved useful.

Spasmodic Asthma. In cases where there occur well- marked parox-
ysms, terminating in the ejection of quantities of mucus, small doses of
sulphate of copper repeated frequently until vomiting occurs will usually
give relief; but independently of vomiting, in asthma of more purely
nervous type, I have observed benefit from - gr. and upward, given
every one to three hours during the attacks, and continued night and
morning in the intervals, so as to secure a tonic effect on the nervous
system.

Whooping- Cough, in the early spasmodic stage, is often relieved by
the same remedy, especially if moderate emesis be produced.

Emphysema Chronic Bronchitis. I have seen relief given to the
dyspnoea dependent on these conditions by small doses of sulphate of
copper continued for some time. I believe it acts partly through the
nervous system, and partly like other astringents, by lessening the amount
of secretion in the bronchi, and so permitting free access of air.

Tapeicorm. I have often known taenise dislodged and passed under
the use of small doses of the sulphate; about gr. in solution is a suitable
amount to commence with, and may be given every morning, fasting. If
this dose be steadily and gradually increased, upward of 3 to 5 gr. may
be administered without causing vomiting or purging; but should these
symptoms occur, the medicine is better omitted for the time, to be re-
sumed in smaller doses if required again. This treatment should be con-



126 MATERIA MEDICA AND THERAPEUTICS.

tinued for eight to ten days or longer, an occasional dose of castor-oil
being given when necessary.

Chronic Diarrhoea and Dysentery. Sulphate of copper is an excel-
lent remedy in these disorders, given in doses of \ to 1 gr., three or four
times daily. Elliotson highly recommended it in somewhat larger doses,
and generally combined with opium in a pill (" Medico-Chirurgical Trans-
actions," vol. xiii. ), but if opium be really required for pain, I find it bet-
ter given separately, especially in the form of Dover's powder, at bed-
time. Morehead also recommends this treatment (" Diseases of India," i.).
In infantile diarrhoea, objection has been taken to the use of copper, but
I have seen it act most beneficially in obstinate cajses, not only when
chronic, but also when acute in character, and especially when connected
with dentition the dose may vary from -fa to ^ gr. several times dailv.
Pereira specially recommends the remedy in ^V-gr. dose. Eisenmann has
also recorded its value in the diarrhoea of dentition, and of weaning, and
states that he has seen many cases treated by it and cured, when others,
not so treated, have become chronic and ended in marasmus (Bulletin,
June 30, 1859).

In the diarrhoea of phthisis, dependent, as it commonly is, on ulcera-
tion of the intestine, we often require to use different forms of astringents,
and the sulphate of copper is a valuable alternative. Small doses only
should be used, in order to avoid nausea and irritation ^ gr. with the
same quantity of opium is advised by Sir T. Watson (" Lectures," ii., p.
216).

In Enteric Fever with severe diarrhoea, a similar combination is highly
praised by Dr. John Harley ("Reynolds' System/' i., p. 419), who " con-
siders it more efficacious than any other medicine." The dose may be
increased up to 1 gr., but must be kept small enough to avoid vomiting;
quite small doses rather allay gastric irritability.

Cholera.- In this malady, the sulphate has been considered by some
physicians so. valuable as to be almost a specific. I cannot place gre*at
reliance upon it, though I have sometimes observed it relieve the cramps,
the retching and purging, and strengthen the weak intermittent pulse,
and assist in warding off collapse. The careful observations of Gutmann
have rendered improbable any specific action of the drug.

Some prophylactic power against cholera has been claimed for copper,
for the neighborhood of towns where large copper-works are situated,
such as Swansea, Birmingham, Rio Tinto, has been markedly free from
the disease, but other circumstances, and other components of the vapor,
such as sulphurous acid, must be taken into consideration (Medical Times,
ii., 1854, ii., 1871). A similar immunity is recorded at the large powder
factory at Madras, where the mixed chemicals are said to be exposed to a
temperature of 500 F., which would be sufficient to develop sulphurous
acid from the sulphur (Mr. Parker: Lancet, ii., 1873). More important is



COPPER. 127

the fact, that among more than 5,000 copper-workers in Paris, not one
was attacked by cholera, during an epidemic which affected other work-
men in the proportion of about 1 in every 140; and of the former, not
one died of cholera in the course of five epidemics (Burq: .Lancet, ii.,
1873). Dr. Clapton also remarked that the copper-workers seemed to
have almost complete immunity from cholera and from choleraic diarrhrea,
when it was very prevalent among the neighbors, and the same observa-
tion has been made by others. Still, such prophylactic virtue of copper
is not usually recognized, perhaps because it is difficult to understand, but
Dr. Clapton suggests as some explanation, the disinfectant power of the
metal, and its destructive action upon fungi; the subject deserves further
investigation.

Croup (Laryngo-Tracheal Diphtheria]. In this malady the sulphate
of copper has been highly esteemed, especially by German and French
physicians, since its first introduction by Hoffmann; he used it mainly as
an emetic, but the question has arisen whether it does not exert a specific
action upon the false membrane. Kissel, who reports successful cases
from the use of non-emetic doses of the acetate, supports this view
(Journal fur Pharmaco-dynamik,), and Missoux, who also speaks highly
of the remedy, but who gave 5-gr. doses, argues in favor of specific action,
because the false membrane, after becoming detached, either does not
form again, or if it does so is no longer so plastic, tough, and adherent
(Bulletin de Therapeutique, December, 1858, abstract in Medico- Chirur-
gical Iteview, ii., 1859). In judging of the curative results, we must bear
in mind the distinction between simple catarrhal laryngitis and the mem-
branous form (true croup), since the former is more likely than the latter
to have a favorable issue independently of treatment, but allowing for
this, there can be no doubt that most of the cases of Godfrey arid of
Beringuier were of the more serious malady; these observers used emetic
doses (2 to 4 gr.) and also depletion. Trousseau used it mainly as an
emetic, in doses of 5 gr., twice repeated (Gazette des Hopitaux, No. 39).
I do not ignore the six fatal cases, recorded by Dr. Hannay (London
Medical Gazette, July, 1840), nor the adverse opinion of Nothnagel, who
fears its injurious effects on the intestinal tract, but still I consider the
remedy of value. Dr. Crighton states (Edinburgh Medical Journal^
May, 1868) that out of fifty cases of croup treated by him with the sul-
phate, only six died; he gave gr. every ten to fifteen minutes till vomit-
ing or marked relief occurred; but even these doses are rather large for
children, and, in fact, he records that two of them had violent diarrhoea.
I recommend doses of ^ to gr. for children, to be given every quarter to
half hour until vomiting is induced; then the dose should be diminished
and given at longer intervals so as to avoid too severe effects, and later it
may be increased again should it become necessary to produce emesis.
This plan may be adopted in true croup during the stage of development



128 MATERIA MEDICA AND THERAPEUTICS.

of the membrane when there is a dry barking cough, and sense of con-
striction across the chest, with much difficulty of respiration: and it is
also serviceable in cases where a loose catarrhal cough assumes a dry
croupy character, when there is partial aphonia, and often some sanguin-
eous discharge from the throat and nostril.

The following notes of an illustrative case have been furnished to me
by Dr. Mackey: E. S., a girl, aged three, was hoarse on April 7th; on
the 9th became feverish and restless, with hurried, loud, and stridulo'us
respiration, and clutching at the throat; there was no exudation on ton-
sils: has had castor-oil, poultices, and steaming, now ordered 6 min. of
ipecacuanha and 6 of antimonial wine every hour: vomited after the
third dose, but the oppression continuing, a teaspoonful of the ipecacu-
anha wine was given and caused freer vomiting.

On the 10th there was, however, no relief, the stridulous croupy
breathing being more marked, the face flushed, not very dusky; pulse
120, respiration 36; drowsy, yet restless. (10 A.M.): to omit other treat-
ment and. take % gr. of copper sulphate every half-hour in water. (1.30
P.M.): has had four doses; vomited freely after the first two, and slept
comfortably; is better, pulse 110, respiration 32. (6 P.M.): one dose
since; vomited and moderately purged; pulse 110, respiration 28, tem-
perature 100; speaks better, and smiles, (llth, 9 A.M.): has slept fairly
well, lying down; had two doses, and vomited after each; looks much
better; respiration 32, temperature 98; bowels moved once. 12th: Con-
valescent, though still some stridor when asleep; an occasional dose of
the copper relieves sensibly. The child got quite well.

Diphtheria. In the ordinary form of diphtheria the sulphate of cop-
per has also been found useful by some observers. Dr. W. Squire speaks
of it as one of the most effectual emetics, and recommends a solution of
5 gr. to the ounce to be given in divided doses a teaspoonful only to
young children, so as to induce moderate vomiting (" Reynolds' System,"
i., p. 147, second edition). In cases of formation of diphtheritic mem-
brane on the cutaneous, or nasal, or vulvar surface, lotions of the sul-
phate are found to destroy it, and to prevent its re-formation.

Intermittent fever. In obstinate quartans, more particularly, the
salt has been commended by Hoffmann, Chapman, and others, in -gr.
doses, combined with opium, but it has not come into general use.

Phosphorus- Poisoning. Bamberger, Eulenburg, and others have
recommended the sulphate as an antidote in this form of poisoning,
which is not uncommon in Germany; the salt certainly is reduced by
phosphorus, and it is supposed that the latter may be coated with the
metal, and thus rendered inert (v. vol. i., p. 43): an emetic effect also is
serviceable, as it is also in narcotic and other cases of poisoning (Noth-
nagel, p. 333).

Syphilis. Aime Martin and Oberlin have recently published the re-



IRON. 129

suits of fifty cases of secondary and tertiary syphilitic affections treated
with sulphate of copper; in many of these it is said to have acted more
promptly than mercury; only in one patient vomiting took place on the
first day, but very soon the metal was borne well; a green margin of the
gums without an inflamed state of the mucous membrane was observed
in a few cases, but disappeared soon; the remedy was given in solution,
and 4 to 8 or 12 milligr. were used daily. To a full bath 20 grammes
were added (Gazette Medicale de Paris, November 15, 1880). Zeissl
has tried copper in syphilis, but his results were only partly satisfactory
( Wien. Med. Presse, November 29, 1880).

PREPARATIONS AND DOSE. Cupri sulphas : as a tonic and astringent,
gr. to 1 or 2 gr. ; as emetic, 5 to 8 gr. (for adults) best administered
in divided doses at short intervals; a child may have -^-to gr., according
to age and strength, repeated every five to fifteen minutes till vomiting
occur ; it should then be omitted for a time, or purging may succeed.
The oxide of copper has been used in doses of to 1 or 2 gr., and the
double chloride with ammonium in or -gr. doses, every two or three
hours. A tinctura cupri acetici has obtained some favor on the Continent
under the auspices of Rademacher. It is prepared by mixing 24 parts of
copper with 30 parts of acetate of lead in 136 parts of distilled water:
boiling this in copper vessels, then adding 104 parts of spirit, and macer-
ating for four weeks in a closed glass vessel, then filtering. It forms a
green liquid of metallic taste, and is the chief remedy for all " copper
diseases," and " especially for hypersemite, stases, and exudations " 5 to
15 drops and upward are given thrice daily (Kissel, Husemann). As a
lotion, 1 to 2 gr. of sulphate in the ounce, as a parasiticide, 10 to 20 gr.
to the ounce may be used, and a stimulating astringent ointment may be
made with ung. sambuci in the same proportion.

[PREPARATIONS, U. S. P. Cuprum ammoniatum, Cupri subacetas,
and Cupri sulphas,~\



FERBUM IRON, Fe, = 56.

Iron, the most abundant and the most useful of metals, occurs exten-
sively in the mineral kingdom, its principal ores being either oxides, as the
magnetic iron ore, or carbonates, as clay iron-stone. It occurs also in many
mineral, so-called chalybeate waters, generally as carbonate with excess of
carbonic acid, sometimes as ferrous chloride or sulphate. In the animal
kingdom it is an essential constituent of blood, being contained, though
only in minute quantity, in the haemoglobin of the red corpuscles. It
occurs largely also in the vegetable kingdom, and may be traced in the
VOL. II. 9



130 JIATERIA MEDICA AND THERAPEUTICS.

ashes of almost all plants. Sometimes the pure metal is found native,
and is then commonly supposed to be of meteoric origin.

CHARACTERS AND TESTS. Iron is hard, malleable, ductile, and of great
tenacity; sp. gr. 7.7. Exposed to moist air, it becomes covered with a
reddish layer rust which is mainly hydrated sesquioxide. It forms two
distinct classes of compounds known as proto- or ferrous salts, and per- or
ferric salts; in the former, it combines with not more than two atoms
of a monad, as Cl or I; in the latter, it requires three, or, as most con-
sider, six atoms of a monad for saturation (" Smith's Commentary "). The
ferrous or proto-salts are commonly lighter in color, less astringent, and
less soluble in alcohol; they have a marked tendency to absorb oxygen,
and to become ferric compounds, hence most of the officinal ferrous salts
are in a partially oxidized state, but to some, sugar is added to prevent
such change as in syrupus ferri iodidi, and ferri carbonas saccharata.
Ferric or per-salts are generally brownish-yellow, astringent, and soluble in
alcohol, and are not prone to change: within the body, however, they are
probably reduced to proto-salts.

The general tests for iron are (1) the color test, with tannic or gallic
acid; (2) the precipitate and blue color produced by ferro-cyanide; and
(3) by ferrid-cyanide of potash. (1) Tannins change the per-salts of iron
bluish-black, and act similarly, though more slowly, with proto-salts. (2)
The yellow prussiate of potash (ferro-cyanide) gives a deep blue precipi-
tate with per-salts of iron, and a whitish or light blue one with proto-salts.
(3) The red prussiate (ferrid-cyanide) gives no precipitate with the per-
salts, but the liquid becomes of a dark color: a deep blue precipitate with
proto-salts (Turnbull's blue).

Sulphuretted hydrogen and ammonium sulphide are also used as tests
for iron salts; thus, in acid solutions of pure ferrous salts, the former
gives no precipitate, while with ferric salts it throws down a nearly white
precipitate of sulphur, with reduction to the ferrous state: Fe 2 Cl 6 + H 2 S
2FeCl a + 2HCl + S. The same tests will also precipitate any copper
contained in acid solutions of iron salts.

By acids iron is readily dissolved, with formation of metallic salts and
evolution of hydrogen.

COMPOUNDS OF IRON.

The large number of officinal iron compounds may be with advantage
considered in the following order: The preparations of the metal itself
and its oxides; the astringent preparations; and those which are not at
all, or not markedly, astringent.



IRON. 131



FERRUM RED ACTUM REDUCED IRON l QUEVENNS?S IRON.

Jtfetallic iron is introduced in the form of soft or wrought iron wire,
or nails free from rust, and also combined with some oxide, as ferrum re-
dactum.

PREPARATION. By passing a stream of hydrogen at red heat over
the hydrated peroxide Fe J O 3 H a O+H (i =4H. 1 O+Fe !1 . At the same time,
by incomplete reduction, some magnetic oxide is formed 3Fe a O 3



CHARACTERS. Pure reduced iron is an impalpable grayish-black pow-
der, strongly magnetic, and showing metallic streaks on firm pressure.
The oxide can be separated from the metal, and its amount ascertained
by digestion with iodine and iodide of potassium, which dissolves the
metal alone; of this, it should contain at least 50 per cent.; a little sul-
phide is sometimes present, and is liable to cause disagreeable eructation.



FERRI OXIDUM MAGNETICUM MAGNETIC OXIDE OF IRON,

Fe 3 O 4 ,=232.

Black oxide containing about 20 per cent, of water.

PREPARATION. This being a mixture of proto- and peroxide, is pre-
pared by adding a mixed solution of proto- and persulphate of iron to an
excess of soda; the precipitate is washed and dried at a moderate tem-
perature (120), for at a greater heat it would absorb oxygen.

CHARACTERS AND TESTS. A brownish-black powder, tasteless,
strongly magnetic, and soluble in acids without effervescence: bubbles
of hydrogen would show the presence of metallic iron.



FERRI PEROXIDUM HUMIDUM MOIST PEROXIDE OF IRON,

Fe a 6HO,=214.

PREPARATION. By pouring solution of persulphate of iron into ex-
cess of soda, and washing away the sodium sulphate: a similar precipi-
tate would be thrown down by potash or ammonia.

CHARACTERS. A pasty mass, reddish-brown in color, and containing
water, both combined and uncombined, to the amount of nearly 90 per
cent.: it is the only iron preparation used in the moist state: it dissolves
readily in cold dilute hydrochloric acid.

1 "Reduced" iron means the metal minutely divided by chemical process as dis-
tinguished from simple filings or powder (mechanical division) ; the percentage of
metal in this form is often small (Pharmaceutical Journal, August, 1875).



132 MATERIA MEDIC A AND THERAPEUTICS.



FEBRI PEROXIDUM HYDRATUMHYDRATED PEROXIDE OF IRON,

Fe 2 O 3 H 2 O,=178.

PREPARATION. By drying the moist peroxide last described at a
temperature of 212, and reducing to powder.

CHARACTERS. A tasteless powder, distinguished from the magnetic
oxide by its dark-brown color, and its being non-magnetic.

(The astringent preparations of iron are mainly those which are formed
by direct solution of the metal in the strong mineral acids, and include
the chloride, nitrate, and sulphate.)



LIQUOR FERR1 PERCHLOR1D1 FORTIORSTRONGER SOLUTION OF
PERGHLORIDE OF IRON, (Fe 2 Cl 6 ,)=325.

PREPARATION. By dissolving iron wire in an excess of hydrochloric
acid (by which a ferrous chloride is obtained), and treating this with ni-
tric acid to peroxidation thus

Fe+2HCl=FeCl 2 +H 2 .

+ 6HCl=3Fe a Cl 6 +2NO+4H a O.



Sufficient distilled water is added to give a sp. gr. of 1.44. The per-salt
could not be fermed by the first-mentioned acid alone, because the nas-
cent hydrogen which is set free, reduces ferric salts to the ferrous state.

CHARACTERS. The liquid is at first black from the combination of
some nitric oxide (NO) with ferrous salt, but on heating the mixture the
gas is expelled, and an orange-brown solution remains: it generally con-
tains some free acid, and has a very strong styptic taste.

Liquor et Tinctiira Ferri Perchloridi (y. p. 180).



LIQUOR FERRI PERN1TRATIS SOLUTION OF PERNITRATE OF



Online LibraryCharles D. F. (Charles Douglas Fergusson) PhillipsMateria medica and therapeutics, inorganic substances; (Volume 2) → online text (page 16 of 40)