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

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water presents a good natural combination for such cases and for chronic
hepatic congestion.) The salt cannot be expected to control fully devel-
oped attacks of biliary colic, but if a dose of 20 or 30 gr. be taken regu-
larly before meals for some months, it seems to have the power of lessen-
ing the calculi, or preventing fresh formations (Bartholow, p. 80); from
larger doses (1 to 2 dr.) of the carbonate in copious draughts of hot water,
Dr. Prout has often seen immediate relief even during the attack of
colic.

In fatty degeneration of the liver we have the authority of Dr. Mur-
chison for saying that large quantities of common salt, eaten with the
food, have proved useful, and there is at least encouragement to try sa-
line waters in this condition (" Clinical Lectures," p. 51). In the case of
ill-conditioned children passing pale and pasty stools, 5 or 10 gr. of the
phosphate taken with meals, will often serve to regulate digestion and
improve nutrition (Stephenson).

Renal Diseases. In cases of calculous (uric acid) diathesis, if it be
desired to keep the system under the continued influence of alkalies, the
salts of soda have sometimes been preferred in weakly dyspeptic subjects,
being less depressing than those of potash commonly used. The waters
of Vichy have a special reputation in such conditions, and under their
influence a urate of soda replaces uric acid in the urine, and is more read-
ily eliminated. The phosphate was especially commended by Liebig and
by Golding Bird as a solvent of lithic deposit.

In Albuminuria it has been recommended to supply alkalies freely to
the blood in order to lessen the liability to inflammation, and to dissolve
fibrinous deposits. It has been taught also that they further the oxida-
tion which is deficient in this dyscrasia, but they can only do so in a
slight degree, if at all. Soda, like other alkalies, may be occasionally
useful in relieving the dyspeptic symptoms, but is no cure for albumi-
nuria, and its prolonged use is contra-indicated by the tendency to anae-
mia.

Diabetes. Speaking not of the temporary and accidental passage of
sugar into the urine, but of the more permanent malady, diabetes, we
find that small doses bf bicarbonate or of chloride of sodium often lessen
the amount of sugar passed (Clarke of New York, and others). -

The citrate, to 1 dr., used, instead of common salt, with the food, is
said " to cure saccharine urine " (Ranking, ii., 1866), and alkaline waters
have been largely used in the treatment of this condition. At Vichy
and similar springs it is found that stout diabetics derive advantage from
the waters, when thin and pale patients do not. Transitory cases, such
as have arisen from temporary nerve-causes, from carbuncle, etc., often
do well at Vichy, and even old-standing cases have been relieved, but



SODIUM. 301

those with marked lesion of the pulmonary or digestive organs are not
suitable for this treatment.

Ebstein reports favorably of Carlsbad and other alkaline waters, espe-
cially for mild cases (Medical Times, i., 1875). According to the theory
of Mialhe, they should help to oxidize burn up sugar in the system,
but their use cannot be based on this hypothesis. Poggiale fed dogs
with non-nitrogenous food starch and sugar to which he added enough
soda to render alkaline the urine, but their blood contained as much glu-
cose as that of dogs fed without any soda; also he injected glucose into
the blood of rabbits, and again injected it mixed with soda, in each case
finding sugar in the urine, while under tartaric acid the sugar disappeared
(Bulletin de FAcademie, 1866, cf. p. 294). Bouchardat, on the other
hand, points out that alkalies may act dangerously in increasing both
fluidity of the blood, and tendency to apoplexy or pulmonary congestion,
and Rabuteau cites several cases that died soon after commencing Vichy
treatment. He suggests that whatever benefit is derived from soda salts
is really due to the chloride, and according to Nasse and others this salt
is deficient in the blood of diabetic patients. Martin Solon (Bulletin
Generale, 1842-43), Constant (These, 1844), and Bouchardat have re-
ported some clinical illustrations of the good effects of salt given as medi-
cine to such subjects.

Struma Phthisis. Some writers have much insisted on the thera-
peutical virtues of salt in these diseases. Durand Fardel reported in-
stances of benefit, and Amedee Latour reduced its administration to a
system; he gave it to well-fed goats, and then used the goats' saline
milk largely in the diet of his patients; he employed also all hygienic
means, and obtained good results (Union Medicale, 1851-56, Brochure,
1857). Pietra Santa is another advocate for the systematic use of salt
in phthisis, recommending a " syrupus natrii chlorati." Dr. Cotton,
however, could not trace any definite effects from salt in his treatment
at Brompton Hospital. The saline baths of Soden, in Nassau, have a
reputation in similar cases, and in obstinate chronic catarrh the waters of
Ems are often prescribed with advantage.

Intermittent Fever. There is evidence of a favorable influence being
exerted by salt in ague and some of its complications. Piory used it,
and Gintrac gave 30 grammes daily with success except in quartans; he
did not verify reduction of the spleen (Bordeaux, 1850), but Herschel
and Rondelet have done so after a more prolonged use of the remedy.
At Bruges, forty-eight cases were reported, and all of them, except the
quartans, were convalescent in three to four days, after taking from 30
to 45 grammes of salt daily, freely diluted; it cleansed the furred tongue
and improved appetite. Out of fifty-two cases reported from Africa the
greater number were cured with 15-gramme doses of salt ( Union Medicale,
1851), and Villemin states that, according to his experience at Damas-



302 MATERIA MEDIC A AND THERAPEUTICS.

cus, common salt stopped attacks of ague six times out of every seven,
-oz. doses being given two, three, or four times ( Gazette Hebdom.
de Med., March, 1854). Mareschkin, a Russian physician, has recently
given further evidence to the same effect (Bulletin Generate de Thera-
peutique, vol. li., p. 183).

Cholera. The carbonate of soda has been used both by the stomach
and by injection in cases of cholera, but the chloride has been more de-
pended upon.

A reasonable argument may be given for its employment, for a main
fact in the disease is profuse discharge by osmosis from the vessels of the
intestinal tract into the alimentary canal; this by itself can determine
the cyanosis, shrunk features, blood stasis, etc. It depends upon a
change in the albuminous constituents of the blood, and is increased by
desquamation of intestinal epithelium, while by saline injections the
physical conditions may be so far altered as to lessen such osmosis. Both
rectal and venous injections have been used, and benefit also has been
traced to salt given by the mouth in cases when the power of absorption
has been retained.

During an epidemic at St. Petersburg (1830) salt water and salt milk
relieved as much as any other remedies. In 1835, at Paris, Bracton re-
ported fifty cases of Asiatic cholera treated with common salt, and only
one was fatal; two tablespoonfuls were given dissolved in 6 oz. of water.
Chomel, Aran, Richard, and others reported good results from the same
treatment in the epidemic of 1865. On the other hand, Husemann con-
cludes that the use of salt has no really good effect, and states that its
intravenous injection has sometimes caused asphyxia. The question can-
not yet be considered decided.

For Dysentery, the sulphate of soda has been much commended by
American writers: 1 dr. is given with -J- gr. pf morphia every two hours,
until natural, though loose, evacuations occur; this treatment is said to
control the malady in two or three days (Neio York Medical Record,
February, 1872).

Constipation. On the other hand, the same remedy -(soda sulphate),
when given in larger doses of - oz., is a useful saline purge in inflamma-
tory conditions, and is an ingredient in several natural aperient waters:
if given with sulphate of magnesia or acid tartrate of potash, smaller
doses (1 to 2 dr.) may be used. The phosphate of soda acts in the same
manner on the intestinal tract, and has a more decided diuretic action;
it renders the urine alkaline. Tartarated soda is an ingredient of Seid-
litz powders.

Uterine Inertia. Borax has some stimulating effect upon the uterus,
as shown by its increasing contraction during labor; it has been used in
lingering cases, though generally combined with ergot and cinnamon; it
is nauseous in taste. Borax has been given also in amenorrhcea, with or



SODIUM. 303

without aloes, and in dysmenorrhcea with belladonna, but is not in gen-
eral use. Since this is the only soda salt that acts upon the uterine sys-
tem, it probably does so through the boracic acid.

JEpistaxis Embolism. Common salt is an ordinary domestic remedy
for bleeding at the nose, and even for haemoptysis, and cases of the
former are sometimes favorably influenced by it when given in drachm
doses. Some attribute any benefit from salt in hemorrhage to the nausea
excited, but it is more likely from a reflex contraction of vessels conse-
quent on irritation of gastric nerves (Husemann). It has been stated
that in embolism,, the collateral circulation becomes better established
under the influence of an alkali (soda carbonate), though the thrombus
itself is not affected (British and Foreign Review, ii., 1861).

PREPARATIONS AND DOSE. Liquor sodce : dose, 10 to 60 min. freely
diluted. Soda caustica. Sodce carbonas : dose, 10 to 30 gr. or more.
Sodce carbonas exsiccata : dose, 5 to 15 gr. Sodce bicarbonas : dose, 10
to 60 gr. Liquor sodce ejfervescens soda water : dose, 2 to 10 oz. or
more each pint contains 30 gr. of bicarbonate of soda. Trochisci sodce
bicarbonatis : dose, 1 to 6 each lozenge contains 5 gr. Sodce arsenias
(v. Arsenic). Sodce sulphas : dose, to 1 oz. Sodce acetas : dose, 20 to
60 gr. Sodce sidphis (not officinal): dose, '20 to 60 gr. (v. Sulphurous
Acid). Sodce hyposidphis (not officinal): dose, 20 to 60 gr. Sodce ni-
tras (for making the arseniate). Sodce phosphas : dose, as a diuretic, 30
to 120 gr. ; purgative, % to 1 oz. given in mutton broth it is almost
tasteless. Sodce hypojihosphis : dose, 5 to 10 gr. (v. Phosphorus). Borax:
dose, 10 to 60 gr. Mel boracis : contains 54 gr. of borax to 1 oz. of
honey. Glycerinum boracis : contains 1 part to 4. Liquor sodce chlo-
ratce ; dose, 10 to 20 min. internally, diluted with 1 or 2 oz. of water; as
gargle, to 1 oz. to pint water. Cataplasma sodce chloratce (solution
of chlorinated soda 2 oz., linseed meal 4 oz., water 8 oz.). Sodii chlori-
dum: dose, oz. or more as an emetic. Soda tartarata (Rochelle salt) :
dose, as a diuretic, 30 to 60 gr. ; purgative, 2 to 4 dr. Sodce citro-tartras
effervescens: dose, 60 gr. to 2 dr. Sodce valerianas (v. Valerian).

[PREPARATIONS, U. S. P. Soda ; Liquor sodce ; Liquor sodce cJilo-
rinatce ; Sodii acetas ; Sodii arsenias ; Liquor sodii arseniatis (4 gr. in
1 oz.); Sodii bicarbonas ; Pulveres effervescentes ; Trochisci sodii bicar-
bonatis (3 gr. of the salt in each) ; Sodii boras ; Glyceritum sodii
boratis : borate of sodium 2 troyounces, glycerin -J pint; Mel sodii bo-
ratis : borate of sodium 60 gr., clarified honey 1 troy ounce; Sodii car-
bonas; Sodii carbonas exsiccata; Sodii chloridum; Sodii hypophosphis ;
Sodii hyposulphis ; Sodii phosphas ; Sodii sulphas.]



304 MATERIA MEDICA AND THERAPEUTICS.



ST ANNUM TIN, Sn,=118 (not officinal).

This metal is known to occur only in the mineral kingdom, and in
minute quantity in the water of Sadschiitz.

CHARACTERS AND TESTS. Silver-white in color, with a tinge of yellow,
and high metallic lustre, unaffected by moisture or exposure, inelastic,
but flexible; when rubbed it imparts to the fingers a peculiar odor. It is
a good conductor of heat and electricity, has a sp. gr. of 7.292, melts at
442 F., and at a higher temperature burns with a brilliant white light;
at ordinary temperatures it is not brittle, but when heated to near the
fusing point may be easily powdered. Nitric acid does not act upon it,
except in presence of water; hydrochloric acid dissolves it with evolution
of hydrogen.

Solution of chloride of tin, SnCl a (Appendix, B. P.), absorbs oxygen
readily, and hence is a powerful deoxidizing agent. It reduces to the
metallic state the salts of mercury, silver, gold, etc., and is made use of
for this purpose; also as a test for ammoniated mercury.

PHYSIOLOGICAL ACTION (INTERNAL). The metal itself is inert, but if
taken into the stomach may be so far acted on by acids or saline sub-
stances as to be rendered soluble in the form of chloride, and may then
produce some irritant effects. The fact of such a change sometimes oc-
curring, and sometimes not, may explain the disagreement between the
results of Orfila, who considered oxide of tin to be a poison, and Schu-
barth, who considered it inert.

It has been said that fatty, or acid, or simply albuminous articles of
food, after having been kept in tinned vessels (free from lead) have some-
times occasioned colic and vomiting, but this must be exceptional. We
may note that arsenic is a usual constituent of tin-ores, and in small
quantity it is generally present in all tin that has not been carefully puri-
fied, and irritant effects may have occurred from it (Gubler).

The chloride, or "butter of tin," is stated to exert a tonic, anti-
spasmodic effect, when given in small quantities, but in large doses it
causes muscular twitching, convulsion, and paralysis; also some gastro-
intestinal irritation, with dryness of mouth and throat.

THERAPEUTICAL ACTION. Intestinal Worms. The powder of tin (tin
filings) has been used as a vermifuge in cases of lumbricus and tscnia.

Trousseau remarks that of all metals after mercury, tin has been in
the highest repute as anthelmintic, and many secret vermifuges contain
either the finely powdered metal or its sulphide: from 30 gr. to oz. have
been given in electuary. Alston gave 1 oz. at a time, but severely
irritant effects sometimes followed. Professor Stillo quotes several au-
thorities in favor of the remedy, and Dr. Graves speaks well of it ("Lec-
tures," ii., p. 248), but it is not now much used, because more dependable



ZINC. 305

medicines have been found. It is supposed to act either mechanically or
by disengagement of hydrogen or other chemical effects. Salts of di-
stann-ethyl have a strong purgative action (Jolyet and Cahours).

In Epilepsy, Chorea, and allied forms of nerve-disorder, the chloride
of tin has been given with benefit, according to the observations of Dr.
Schlessinger ( Medico- Chirurgical Jleview, October, 1838, and April,
1846).

In Chronic Skin Diseases, the same physician recommends it both in-
ternally and in lotion, but its real value is not ascertained.

PREPARATIONS AND DOSE. Pulvis stanni (not officinal) : dose, 20 to
40 gr. as a vermifuge it may be given in honey or treacle three or four
times daily for several days, and should then be followed by a cathartic.
Stanni chloridum : dose, -fa to gr. two or three times daily in pill or in
chloric ether a lotion may be made with 1 gr. to the ounce.



ZINCUM ZINC, Zn,=65.

This mineral is obtained, for commercial purposes, mainly from two
ores the carbonate (calamine) arid the sulphide (blende) by distillation
with carbon. It has been found also in plants which grow on the cala-
mine hills of Rhenish Prussia. It is liable to contain arsenic, iron, cop-
per, and sulphur. Alloyed with copper, zinc forms brass; with nickel,
"German silver." It is extensively used in galvanic combinations, and
forms the positive plate of many voltaic batteries; as a coating on iron
(galvanized iron) it protects from oxidation. Granulated zinc is prepared
by pouring the molten metal into cold water.

CHARACTERS AND TESTS. Zinc is a brittle bluish-white metal, which
at a red heat burns with a brilliant flame, and emits white fumes of oxide;
sp. gr. 7. It is the only metal which yields a white sulphide with sulphide
of ammonium, and hence this reaction is the characteristic test for it.
Fixed and volatile alkalies also give with zinc white precipitates, soluble
in excess of the reagents.

*
COMPOUNDS OF ZINC.

ZINC1 OXIDUM OXIDE OF ZINC, ZnO,=81.

PREPARATION. By exposure of the carbonate to a dull red heat until
all the carbonic acid is driven off. " Hubbuck's " oxide of zinc is ob-
tained by combustion of the metal in air.

CHARACTERS AND TESTS. A white heavy powder, without taste or
odor, insoluble in water, soluble in acids; moderate heat renders it yel-
VOL. II. 20



306 MATERIA MEDICA AND THERAPEUTICS.

low. Commercial specimens are often impure from presence of carbon-
ates, sulphates, chlorides, iron, etc.



ZINCI CHLORIDUM- CHLORIDE OF ZINC, ZnCl,,=136.

PREPAKATION. By dissolving zinc in hydrochloric acid, and evaporat-
ing the solution; chlorine water is then added (to combine as chloride
with the iron usually present), and afterward zinc carbonate, which forms
more zinc chloride and precipitates ferric oxide.

CHARACTERS. Chloride of zinc is soft, white or semi-transparent,
crystalline or waxy, and is met with either in opaque tablets or in pen-
cils like nitrate of silver. It is very soluble and deliquescent, but if
mixed with an equal part of oxide (oxychloride), may be kept dry for a
long time.

ZINCI SULPHAS SULPHATE OF ZINC WHITE VITRIOL,
ZnSO 4 7H 2 O,=287.

PREPARATION. By dissolving zinc in dilute sulphuric acid: chlorine
water and carbonic of zinc are added, as in the last preparation, and for
the same purpose, viz., to remove any iron that may be present.

CHARACTERS. Occurs in prismatic crystals, which may be large or
small. The latter much resemble in appearance those of sulphate of
magnesia, but their strong styptic taste will distinguish them from the
bitter maguesian salt (v. p. 233) : they redden litmus and effloresce in
air.



ZINCI CARBONAS CARBONATE OF ZINC, ZnCO 3 (ZnO) 2 2H 2 O, =341.4.

PREPARATION. By adding carbonate of sodium to a boiling solution
of sulphate of zinc, and drying the precipitate; if cold solutions be used,
the precipitate is gelatinous. (The compound formed is really a hydrated
oxycarbonate, as in the formula.)

CHARACTERS. A soft, white powder, resembling magnesia, insoluble
in water, tasteless and inodorous. The native impure carbonate (cala-
mine, lapis calaminaris) was formerly officinal, but the pink powder sold
under that name was almost always spurious, consisting of barium sul-
phate colored with iron.



ZINCI ACETAS ACETATE OF ZINC, Zn(C i H 3 O 2 ) 2 2H i O,=219.

PREPARAT ON, etc. By dissolving the carbonate in acetic acid. Oc-
curs in thin, ustrous, micaceous plates, having a sharp astringent taste.



ZINC. 307

ZINCI VALERIAN AS VALER1ANATE OF ZINC, Zn(C.H,O,),=267.

PREPARATION. By mixing concentrated solutions of sulphate of zinc
and valerianate of sodium.

CHARACTERS.- Occurs in brilliant scaly crystals, which have an odor
of valerian, and a metallic taste; soluble slightly in cold water or ether,
freely in hot water and in alcohol. It is liable to be contaminated with
butyrate of /.inc.

ABSORPTION AND ELIMINATION". Soluble salts of zinc, such as the
chloride, sulphate, and acetate, are readily absorbed, and pass into the
blood probably as albuminates. The oxide and the carbonate are also
dissolved to some extent by the acids of the gastric juice, and then slowly
absorbed; independently of clinical evidence of this, the oxide has been
detected by Schlossberger in the urine, and by Micbaelis in venous blood.

Zinc does not seem to be deposited in the tissues in the same manner,
or for so long a period, as mercury, lead, or copper, although recently
Lechartier and Bellamy have detected it in the bodies of animals to
whom the metal had been previously administered (Medical JKecord, \.,
1877). The soluble salts are eliminated soon after being taken, but the
insoluble ones are not found in the excretions until four or five days after-
ward (Michaelis). The metal passes out mainly by the bile and the intes-
tinal secretions; in smaller amount by the urine.

PHYSIOLOGICAL ACTION (EXTERNAL). The oxide and the carbonate
of zinc, in powder, act mechanically as absorbents and sedatives. The
sulphate and the acetate, in the solid state, act as efficient, but not very
severe, caustics, if the epidermis be removed: in dilute solution they act
as astringents. The chloride and nitrate exert a strongly caustic effect
by virtue of their affinity for water, and their power of coagulating albu-
minous material; the former especially, being deliquescent, penetrates
deeply into the tissues, and causes severe burning pain; the eschar pro-
duced is white and hard, and separates in five or six days; when formed
from deep tissues it is of spongy character, but dry on exposed surfaces.
Zinc chloride is a powerful disinfectant, and even in dilute solution
proves fatal to germs, vibriones, etc.; according to Calvert's experiments,
it is only equalled in efficacy by mercurial chlorides and the tar acids
(Lancet, ii., 1873; Medical Times, ii., 1852, p. 101).

PHYSIOLOGICAL ACTION (INTERNAL). Digestive System. The oxide
and carbonate, in doses of a grain and less, exert an astringent and some-
what sedative action on the gastro-intestinal tract, markedly lessening
its secretions. The sulphate, in small, non-irritant doses, is still more
astringent. All zinc compounds have a tendency to excite nausea and
irritation of the stomach; the oxide and the carbonate, though tasteless,
show this effect when given in doses of from 1 to 5 gr. and upward.
The soluble salts have a styptic metallic taste, and the sulphate, in doses



308 3IATERIA MEDICA AND THEKAPEUTICS.

of 5 to 10 gr. and upward, acts as a prompt and thorough emetic without
much nausea or prostration, though often with diarrhoea: this action is
not purely a local one, because it is equally produced by intravenous in-
jection of the salt. Emesis, however, is not a constant effect, for if the
drug be taken at first in small doses and continued regularly, a certain
tolerance is established, and then 10 to 20-gr. doses may be taken with-
out disorder of the stomach. Caution is required in the continuance
even of small doses, since they have been said to cause ulceration of mu-
cous membrane, and ultimately symptoms like those of lead-poisoning,
such as emaciation, anaemia, debility, fetor of breath, constipation, and
colic, also tremor, paralysis, etc. Symptoms of acute irritant poisoning,
such as pain, vomiting, convulsion, and collapse, have followed doses of
30 to 60 gr., and sometimes concentrated solutions have caused death
(Medical Times, ii., 1862, p. 252), but the salt has rarely proved fatal,
because of its being so soon rejected; persons have recovered after taking
an ounce or even more.

The chloride is much more corrosive in character, and is unsuited for
internal use 5 to 10 gr. have produced severe irritant symptoms. It
has been a not infrequent source of fatal poisoning in the form of Sir
W. Burnett's disinfecting fluid, which is an impure solution of it, some-
what oily in character, and either colorless or of yellowish tinge, from
the presence of some ferric oxide: it has been mistaken for fluid mag-
nesia, for mineral waters, and for pale ale, the fact of its frothing up
when shaken contributing to its resemblance to the last-mentioned : one
fl. oz. has been found to contain from 100 to 372 gr. of solid chloride
(Taylor), 200 gr. (R. "W. Smith), and less than that quantity has proved
fatal, though not invariably.

Nervous System. The oxide of zinc has been credited with a special
action on the nervous system, of tonic character in small, but depres-
sant in large doses. Dr. Marcet traced drowsiness to its use, and others
have recorded giddiness after taking it, and generally depressed ner-
vous and mental conditions from the prolonged continuance of large
doses (Medical Times, 1858; Medico- Chirurgical Review, ii., 1861).
In cases of ultimate recovery from the effects of large doses of zinc
salts there have been, besides the gastric symptoms, signs of impaired
nerve-power, with perversion of taste and smell, tremor, or partial paral-
ysis. Exposure to fumes of the molten metal, as in the course of cer-
tain metallic castings, gives rise to a curious train of symptoms, mainly
nervous, and commonly known as " brass-founders' ague," and including
general malaise, tightness of chest, a cold stage with rigors, followed by a



Online LibraryCharles D. F. (Charles Douglas Fergusson) PhillipsMateria medica and therapeutics, inorganic substances; (Volume 2) → online text (page 37 of 40)