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

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that its value in phthisis is not better known " (British and Foreign He-
view, i., 1872). On the other hand, Dr. Flint's observations satisfied him
of benefit from the drug in only one out of fourteen cases, mostly ad-
vanced (American Quarterly Heview and Medical Times, ii., 1861). Dr.
Cotton could trace no definite effects to it, though it seemed to improve
the vigor of cachectic individuals generally. I have myself known the
carbonate as well as the chlorate relieve pleuritic stitches, diminish pro-
fuse purulent expectoration, and check copious perspiration.

Chronic Hoarseness Aphonia. In these conditions, whether con-
nected with chronic chest-disorder (not laryngeal phthisis) or with over-
exertion in talking or singing, I have frequently prescribed from 5 to 15
min. of liquor potassae with advantage; in fact this simple remedy, given
every four hours for a few days, has quickly relieved and sometimes quite
cured the symptoms.

Struma Asthenia. Many observers agree in attributing benefit to
the chlorate in strumous asthenic conditions, more or less allied to phthi-
sis. Dr. Harkin used it in all forms of scrofulous glandular ulcerations.
Mr. Weeden Cooke praised it in " scrofula," and in the generally im-
paired condition which follows exanthematous disease (Lancet, ii., 1869).
It has also acted well in improving the general state during pregnancy,
and even in preventing the recurrence of abortion (Edinburgh Medical
Journal, 1866). The early reputation of potash in struma was founded



1 Mr. Whymper has recently reported its good effects in relieving headache, and
other symptoms induced by highly rarefied air, at an altitude, e.g., of 16,500 feet on
Chimborazo ; it was recommended to him by Dr. Marcet.



POTASSIUM. 283

mainly on the success of Brandish with liquor potassas, but good air and
hygiene were essential elements in his cures. This medicine will some-
times induce the absorption of glandular tumors, but cannot be consid-
ered curative of the constitutional taint; it is now practically replaced by
iodide of iron and cod-liver oil.

Suppuration Ulceration of Mouth. In cases of suppuration, such
as carbuncle or continued eruption of boils, or discharging wounded sur-
faces, also in sloughing or gangrene, the chlorate and permanganate have
been found useful internally as well as locally, but it is especially in ulcer-
ation about the mouth, the gums, and the fauces that chlorate of potash
is most valuable. Mr. Hutchinson has recorded many cases occurring in
unhealthy children, and very obstinate until this remedy was given in full
doses of from 10 to 30 gr. (Medical Times, ii., 1856). Mr. Hunt" intro-
duced it as a specific in ulcerative and gangrenous stomatitis (" Medico-
Chirurgical Transactions," xxvi.), and I consider it a most valuable rem-
edy when used internally and locally in these affections. In relaxed sore
throat and catarrhal pharyngitis the chlorate is often serviceable, and is
commonly prescribed in the form of lozenge.

In mercurial stomatitis it has proved useful (Herpin, Hutchinson,
etc.), and Ricord administered it with mercury to obviate injurious effects
from the latter. Sir T. Watson quotes a formula containing the chlorate
10 gr., with an equal quantity of sulphur, as " almost a specific," but my
own experience is rather that of Bartholow and some other observers,
viz., that the chlorate does not give, in mercurial maladies, the same good
results as in ordinary stomatitis.

Diarrhoea. The chlorate of potash has been recommended in dysen-
tery, and even in inflammatory diarrhoea (Amisy : Lancet, ii., 1872, p. 300).
Marotti considers the acetate valuable in gastro-intestinal disorder con-
nected with chronic catarrhal conditions and increased secretion of mucus
in the alimentary canal, an.d marked by coated tongue and anorexia
(Practitioner, vol. ii.), but I think we have more dependable remedies.
I should rather avoid it in acute conditions of this kind, but in the form
connected with advanced stages of chronic nerve-disorder and cachexia, or
" vaso-paraly tic " diarrhoea, its use is more indicated. The chlorate is an
ingredient in the " saline treatment " of cholera.

Constipation. The sulphate of potash acts as a mild aperient, and is
suitable for cases of dyspepsia with deficient biliary secretion, or hemor-
rhoids; it is often combined with rhubarb, especially for children (West,
Hillier). Dr. Dickinson recommends it in doses of 10 to 20 gr. as a good
laxative in albuminuria (Lancet, i., 1876, p. 628); in larger doses it is apt
to cause griping. The acid tartrate is also used as an aperient, especially
in cases of hemorrhoids and of dropsy, since it produces a copious watery
secretion into the intestinal canal, but it should be combined with some
more active agent to secure efficient expulsive effect; thus it is ordered



284 MATEBIA MEDICA AND THERAPEUTICS.

with sulphur in the confectio sulphuris, and with jalap in the puivis ja-
lapse compositus.

Purpura Scorbutus Hemorrhage. In purpura simplex, 10-gr. doses
of nitrate of potash have been sometimes useful, and even in hemorrhagic
purpura the same remedy in large doses (10 to 60 gr.) has been recom-
mended (Carlyon). The advantage of potash salts in true scurvy is not
clear, but for the special ulceration of the gums, the chlorate is certainly
good (Lancet, ii., 1860, etc.). Both the nitrate and the tartrate are of
service in the treatment of capillary hemorrhage; the former has been
used, especially in haemoptysis accompanied with febrile excitment (Gib-
bon), and the latter in hemorrhage from the kidney, bladder, and rectum.
Half-drachm doses of the acid tartrate quickly arrested a hemorrhage
connected with a malignant growth of the bladder, and 2 dr. is an effi-
cient dose for relieving the loss of blood from piles (Ramskill: British
Medical Journal, i., 1867).

Cirrhosis of the Liver. The acid tartrate of potash is said to be " of
singular value in alcoholic cirrhosis " (Gull: Lancet, i., 1866, p. 6).

Obesity. There are on record some remarkable cases in which the use
of potash salts, and especially of liquor potassae, has reduced the amount
of fat deposited, but these remedies are by no means always effective for
this purpose, nor should they be employed without real necessity and due
care, for fear of inducing a spansemic condition. In a case of local exces-
sive deposit of fat round the neck of a girl, which was very unsightly, and
for which no available treatment could be at first suggested, the use of 15
to 20 min. doses of liquor potassas ter die, led to marked improvement,
and so quickly as to be clearly traceable to the remedy (Lancet, i., 1873).
In some other cases of fatty tumor, liquor potassse has also been given
with success as regards diminution of the growth.

Diabetes. The use of alkalies in this malady was at one time largely
adopted, in the hope that their property of assisting oxidation would be
of direct service, but this hope has been in the main disappointed. The
permanganate especially was recommended by Sampson (Lancet, i.,
1853), and also by Ramskill (Medical Times, ii., 1867), but has not
proved reliable (Bence Jones, Basham, and others) : it seems, however,
to have the power of relieving the intense thirst of the malady. The
compound alkaline waters of Vichy, Carlsbad, etc., really ameliorate many
cases (v. vol. L, p. 161). The nitrate, chlorate, and tartrate are. also ser-
viceable in polydipsia, and are given dissolved in water or lemonade: the
citrate in effervescence may give much temporary relief.

Albuminuria Dropsy. The use of alkaline diuretics is advanta-
geous in the early stages of this malady, the citrate of potash or the ace-
tate being the most suitable; they are presumed to act directly on the
kidney, washing away debris and epithelium, which obstruct the tubules.
In later stages, when dropsy is present, and indeed in all forms of dropsy,



POTASSIUM. 285

20-gr. doses of the acetate, or half that quantity of nitrate, given in con-
junction with digitalis, squill, or other vegetable diuretics, often secure
a copious secretion from the kidneys.

Cyanosis. Although, as before remarked, the theory of oxidation of
the blood by means of chlorate of potash cannot be scientifically main-
tained, yet I have certainly seen benefit from that salt in cases of con-
genital cyanosis: the color and the temperature have both improved un-
der its continued use. Dr. Balthazer Foster has recorded two remarkable
cases, in which he obtained similar results (" Clinical .Medicine "). Mr.
Harding found it (the chlorate) useful "in cases with lividity, and cold-
ness of lips and extremities, and symptoms of obstructed circulation "
(Medical Times, ii., 1861), and Dr. Fountain and others have had the
same experience.

Tetanus Chorea. The power of potash to alter and diminish the
contractility of muscular tissue, furnishes some theoretical ground for an
old method of treatment of tetanus by means of potash-baths, and the
internal administration of the carbonate, "the method of Stiitz " (Huse-
mann): practically, this is not often employed, but some cases in which
it was successful may be found recorded (Lancet, i., 1861). In chorea,
also, baths of the same kind have been found beneficial by G. See and by
Hillier. The internal administration of potash may be desirable, for a
time, at least, in cases with rheumatic taint, but must not be pushed to
the production of spansemia.

Blood- Poisoning Pycemia. The influence of potash upon oxidation,
and upon the blood-condition, have led to its employment in cases of
absorption of poisonous material.

Savory has found it of distinct value, not in acute, but in chronic
pyjemia (Lancet, i., 1867, p. 202), and Sir James Paget records the disap-
pearance of a chronic pysemic abscess under the use of liquor potassce
(St. Bartholomew's Hospital Reports, vol. i.).

Snake-bite. Dr. Shortt, the eminent ophiologist of Madras, has re-
corded indisputable evidence of its value when quickly and largely used
after the bite of venomous snakes. He gives it in several ways in order
to saturate the blood as soon as possible: thus internally, 20 min. are or-
dered with 1 oz. of brandy and oz. of water; 1 dr. is injected into the
veins every hour, and general and local bathing with a strong solution (4
oz. to the bath) is constantly practised (Medical Times, ii., 1873). 1

Syphilis. By those who decry or discourage the use of mercury in
syphilis, the chlorate of potash is much depended upon as a substitute,
especially in infantile forms of the disorder (Drysdale: Dublin Press,



1 M. de Lacerda has recently reported that intravenous injection of a 1 per cent.
solution of permanganate, soon after an injection of snake venom, has proved anti-
dotal in dogs (October, 1881).



286 MATEKIA MEDIC A AND THERAPEUTICS.

December, 1862). I believe that it may contribute to the healing of
ulceration in this as in other cachexice, but I cannot attribute to it spe-
cial anti-syphilitic power. More has been claimed for the bichromate,
and it seems to have proved sometimes useful, especially in ulcerated
throat (syphilitic) and in iritis; a pill containing ^V to i e r -> w ^ ta opium,
is the best way of giving it, for its solution is apt to nauseate. In large
doses it is an irritant poison, and its action as a remedy has not been well
proved nor extensively tried. I have myself been greatly disappointed
with its effects in some obstinate cases of syphilitic disease.

PREPARATIONS AND DOSE. Potassii bromidum (v. vol. i., p. 119). Po-
tassii iodidum ; Linimentum potassii iodidi cum sapone (v. vol. i., p. 94).
Liquor potassce : dose, 10 to 60 min., freely diluted. Potassa caustica.
Potassce carbonas : dose, 10 to 20 gr., freely diluted. Potassce bicarbonas :
dose, 10 to 30 gr. as an antacid, etc. ; in acute rheumatism, 30 to 60 gr.
every four hours, freely diluted with water. Liquor potassce ejfervescens :
" potash water," dose, 4 to 8 oz. (contains gr. in the ounce). Potassce
acetas : dose, 10 to 60 gr. as a diuretic; 120 gr. and upward as a purga-
tive. Potassce citras : dose, 20 to 60 gr. Potassce tartras : dose, 20 to 60
gr. as a diuretic and alterative; 120 to 200 gr. as a purgative. Potassce
tartras acida : dose, 20 to 60 gr. as a refrigerant or diuretic; 120 to 300
gr. as a hydragogue purgative (contained in confect. sulphuris). Potassce
sutyhas : dose, 20 to 120 gr. as a purgative; smaller doses as an altera-
tive. Potassce nitras : dose, 5 to 20 gr. as a refrigerant and diuretic; 20
to 30 gr. as a vascular sedative. Potassce chloras : dose, 5 to 20 gr.
Trochisci potassce chloratis : 5 gr. in each lozenge. Potassce permanga-
nas : dose, to 4 gr. Liquor potassce permanganatis (contains 4 gr. to
the ounce for external use, 1 fl. dr. to 5 or 10 oz. of water). Potassa
sulphurata: dose, 3 to 6 gr. in pill (often used in much smaller doses in
pill or in water fa gr. or even less for children). Unguentum potassce
sulphurate (should be recently prepared). Sapo mollis.

[PREPARATIONS, U. S. P. Potassa; Potassa cum, calce (equal parts
of potash and lime) ; Liquor potassce ; Potassii acetas ; Liquor potassii
arsenitis (4 gr. in 1 oz.); Potassii bicarbonas; Potassii bitartras ; Po-
tassii bromidum ; Potassii carbonas ; Potassii carbonas pura ; Potassii
chloras ; Trochisci potassii chloratis (5 gr. of the salt in each); Potassii
citras; Liquor potassii citratis; Mistura potassii citratis neutral mix-
ture; Potassii iodidum ; Unguentum potassii iodidi (60 gr. in 1 oz.);
Potassii nitras ; Potassii permanganas ; Liquor potassii permanganatis
(4 gr. in 1 oz. ) ; Potassii sulphas ; Potassii sulphuretum ; Potassii tar-
tras ; Potassii et sodii tartras Rochelle salt; Pidveres effervescentes
aperientes Seidlitz powders.]



SODIUM. 287



SODIUM XATKIUM, Ka,=23.

This metal does not occur native, but in various combinations is found
extensively throughout all the kingdoms of nature; the chloride espe-
cially is abundant in the animal organism, also in sea-water, in many
mineral springs and marine plants, as well as in mineral formations. The
nitrate of soda occurs as an efflorescence on the soil in some countries.

CHARACTERS AND TESTS. Sodium, the metallic base of soda and its
compounds, is of waxy consistence, and silver-white color. It has a great
affinity for oxygen, and when placed upon water floats like potassium,
producing effervescence from escape of hydrogen, and combining with the
oxygen of the water to form soda: the sp. gr. is 0.972. Sodium is the
only metal of which the ordinary salts are all soluble in water, and there-
fore do not furnish precipitation tests: we have, however, an excellent
reaction in the flame-test, i.e., the communication of an intensely yellow
color to a clear flame; so delicate is this test, and so universally diffused
are the compounds of sodium, that it is difficult to obtain a flame per-
fectly free from all traces of them (Smith).



COMPOUNDS OF SODA.

SODA CAUSTIC A CAUSTIC SODA HYDE ATE OF SODA, NaHO,=40.

PREPARATION. By evaporating liquor sodse to dryness in a silver or
clean iron vessel; the process is conducted as rapidly as possible to pre-
vent absorption of carbonic acid, arid plantinum, glass, or porcelain ves-
sels are not admissible because the alkali would act upon them. A pure
hydrate is now prepared by decomposing water with* metallic sodium.

CHARACTERS. Occurs in whitish cakes or pieces which are highly al-
kaline and corrosive: it is not so deliquescent as potash.



LIQUOR SOD ^E SOLUTION OF SODA.

PREPARATION. By adding slaked lime to hot solution of carbonate of
sodium, Na 2 CO s + CaH a O 2 -CaCO 3 + 2NaHO.

CHARACTERS. A colorless liquid, of intensely caustic taste, contain-
ing nearly 19 gr. of caustic soda to the ounce.



CARBON AS CARBONATE OF SODA, Na 2 CO 3 10H 2 0,=286.

PREPARATION. This is carried out on a large scale for commercial
purposes, and is not described in the Pharmacopeia. The combustion



288 MATERIA MEDIC A AND THERAPEUTICS.

of sea plants formerly furnished us with crude soda-ash, or " barilla,"
from which the carbonate was prepared, but it is now generally obtained
from common salt (chloride of sodium) either by Leblanc's process of
treatment with sulphuric acid, to form a sulphate known as " salt-cake,"
which is strongly heated in a furnace with chalk and charcoal, and after-
ward the carbonate is crystallized out; or by "the ammonia process," in
which the bicarbonate of ammonia precipitates from the salt solution a
bicarbonate of soda, and from this the carbonic acid is driven off by heat,
to be utilized in other steps of the manufacture.

CHARACTERS. Occurs in large rhombic crystals, colorless and trans-
parent when fresh, but readily efflorescing on exposure to air; of nau-
seous alkaline taste, very soluble in water, not at all in alcohol: they con-
tain 63 per cent, of water of crystallization, which they lose at a sufficient
heat. Twenty grains of carbonate of soda neutralize 9.7 gr. of citric and
10.5 of tartaric acid.

Sodce Carbonas exsiccata, or dried carbonate of soda, being the same
salt deprived of water and powdered, is introduced as a separate prepara-
tion for convenience in dispensing: 1 gr. =about 2 gr. of the crystallized
salt.

SOD^l BICARBONAS BICARBONATE OF SODA, NaHCO 3 ,=84.

PREPARATION. By passing a stream of carbonic acid gas into a mix-
ture containing two parts of the crystallized and three parts of the dried
carbonate, until the gas ceases to be absorbed. (If the ordinary carbon-
ate only were used, the mass would become too moist, and the crys-
tals too large): by a special arrangement of vessels, the delivery of the
carbonic acid is made continuous, as in the case of bicarbonate of pot-
ash.

CHARACTERS. Occurs in small snow-white grains or scales, or in
opaque white powder, slightly alkaline, and somewhat caustic to the
taste, permanent in the air, and soluble in water. Good commercial bi-
carbonate commonly contains 2 or 3 per cent, of carbonate. Twenty
grains of the former salt neutralize 16.7 gr. of citric and 17.8 of tartaric
acid.

Sodce Arsenias (v. p. 26).

SOD^l SULPHAS SULPHATE OF SODA GLAUBERS SALT,
Na 2 S0 4 10H 2 0,=322.

PREPARATION. In the process for making hydrochloric acid, an acid
sulphate of soda is formed by the action of sulphuric acid on common
salt, and if this acid sulphate be neutralized with carbonate of soda, the
neutral sulphate may be crystallized out.



SODIUM. 289

CHARACTERS. Occurs in transparent colorless six-sided prisms, which
are deeply channelled; they are efflorescent in the air, and have a saline
bitter taste and neutral reaction.



ACETAS ACETATE OF SODA, NaC 5 H 3 ;1 3H s O,=136.

PREPARATION, etc. By neutralizing carbonate of soda with acetic
acid: occurs in long striated prisms, which slowly effloresce, and have a
sharp, bitter taste.



HYPOSULPniS HYPOSULPHITE OF SODA (SODIC THIOSUL-
PHATE), NaaHiSjCMHaO (not officinal).



PREPARATION, etc. By warming a solution of the sulphite with pow-
dered sulphur: occurs in large colorless oblique prisms, which are very
soluble in water, not in alcohol.



SOD^E NITRAS NITRATE OF SODA, NaNO 3 ,=85.

PREPARATION, etc. This salt is found native in Peru and Chili, and
is purified by crystallization from water. It occurs in the form of obtuse
rhomboids, resembling cubes, deliquescent, and very soluble.



PHOSPHAS PHOSPHATE OF SODA, N 3 HP0 4 12H 2 O, =358.

PREPARATION. Obtained from bone-ash, which is mainly phosphate of
lime, by rather a complex process, of which the essential steps are two,
viz.: (1) The bone-ash is digested with sulphuric acid, when an acid
phosphate is formed and remains in solution, and an insoluble sulphate
precipitates. (2) The filtered solution containing the acid phosphate of
lime is then treated with carbonate of soda to slight alkalinity, when
phosphate of soda is formed, filtered, and re-crystallized.

CHARACTERS. Occurs in large, transparent, rhombic prisms, which
quickly effloresce in the air; they are faintly alkaline, very soluble in
water, and have a mild saline taste.



SOD^E HYPOP110SPHI8HYPOPHOSPHITE OF SODA, NaPH,O,,=83.

PREPARATION. By adding carbonate of soda to solution of hypophos-
phite of lime, so long as a precipitate (carbonate of lime) is formed; this
is filtered off, and the solution evaporated cautiously.

CHARACTERS. A white, crystalline, bitter salt, deliquescent, and very
VOL. IL 19



290 MATERIA MEDICA AND THERAPEUTICS.

soluble in water and spirit. It readily decomposes, so that explosions
occur with it on mixture, for instance, with chlorate of potash and fric-
tion; and when heated to redness it ignites, and gives off phosphuretted
hydrogen.

SODJE B1BORAS BORAX, Na 2 B 4 O,10H a O,=382.

PREPARATION. Found native in a crude form in Thibet, India, Cali-
fornia, etc. ; also prepared by neutralizing boracic acid with carbonate of
soda.

CHARACTERS. Occurs in flattened semi-transparent prisms, of slightly
alkaline reaction and saline taste, soluble in water, and efflorescing in the
air. Its solubility is increased by glycerin and by cream of tartar, and
from its solutions boracic acid is precipitated by any mineral acid: it
gives a green color to flame. When heated it dissolves in its water of
crystallization, and at red heat forms a transparent glass much used as a
flux for mineral substances in blow-pipe operations.



LIQUOR SODJE CHLORATE SOLUTION OF CHLORINATED SODA.

PREPARATION. By passing washed chlorine gas through a solution of
carbonate of soda, till a sp. gr. of 1.06 is reached. The resulting solution
contains hypochlorite of soda, with some chloride and bicarbonate of the
same.

CHARACTERS. A .colorless alkaline liquid, with the odor of chlorine,
and a pungent taste; sp. gr. 1.103; it bleaches vegetable colors, effer-
vesces with acids, and readily e.volves chlorine.



SOD II CHLOR1DUM CHLORIDE OF SODIUM COMMON SALT,

NaCl,=58.5.

Is found native in." rock-salt " and saline waters.

CHARACTERS. Occurs in transparent cubes or small white grains, solu-
ble in water, and if pure, permanent in air: deliquescent, if containing
chloride of calcium or magnesium.



SODA TARTARATATARTARATED SODATARTRATE OF SODA AND
POTASH ROCHELLE SALT, NaKC4HO 6 4H 2 O,=282.

PREPARATION. By adding cream of tartar to a hot strong solution of
carbonate of soda, so long as effervescence continues, then filtering and
crystallizing.



SODIUM. 291

CHARACTERS. Occurs in large, colorless, rhombic prisms, or halves of
prisms, which have been compared to tombstones: they are neutral in re-
action, soluble in water, and of saline rather bitter taste.



CITRO-TARTRAS EFFERVESCENT EFFERVESCENT CITRO-
T ART RATE OF SODA.

PREPARATION, etc. By mixing bicarbonate of soda with citric and
tartaric acids, at considerable heat (200 F.); with constant stirring, this
salt is obtained as a granular powder, which effervesces on contact with
water.

ABSORPTION AND ELIMINATION. The salts of soda, like those of pot-
ash, are highly diffusible and readily absorbed. Small doses become
changed in the stomach into chloride, but large quantities undergo this
change only in part, the rest being absorbed unchanged; from the rectum
also, soda salts are absorbed without chemical decomposition. In the
blood they circulate as albuminates, carbonates, phosphates, etc., and are
eliminated mainly by the urine: the carbonates, nitrates, and other salts
of mineral acids in their natural state, but citrates and other salts of
vegetable acids pass out as carbonates.

The time that elapses between absorption and some elimination is not
precisely known, but is short, for the nitrate and an excess of chloride
have been found in saliva and urine within a few minutes after the taking
of those salts; also, a very large quantity (60 grammes) of nitrate has
been taken in divided doses during a day without injury, while half the
amount in one dose has proved poisonous.

The chloride taken into, or formed in the stomach, is said to decom-
pose into hydrochloric acid and soda, the former passing into the blood
to combine again there with soda (bicarbonate), while the latter is elimin-
ated, not only by the kidneys, but also by the salivary glands, the liver, the
pancreas, etc. (Bidder and Schmidt). The chloride is never completely
eliminated from the system even if it be. excluded from the diet: on the
other hand, if an excessive quantity be taken, most of it is rapidly got
rid of: thus, Lehmann, analyzing his blood before and during the action
of a salt-dose or salted diet, found the proportion of salt in the blood to
be very similar, the excess being passed out by the kidneys almost as



Online LibraryCharles D. F. (Charles Douglas Fergusson) PhillipsMateria medica and therapeutics, inorganic substances; (Volume 2) → online text (page 35 of 40)