The physiological action of various mineral acids locally applied, such as the phosphoric, nitric, hydrochloric, sulphuric, are so much alike in their general action that it is not necessary to classify them separately. All strong acids are escharotic. They destroy protoplasm, combine with albumen and abstract the water from all tissues. The phosphoric and the sulphuric acids will completely decompose tissues and have a strong affinity for water. Most of these acids will again dissolve albumen after precipitation, with the exception of nitric acid, which does not. Nitric and hydrochloric will cause a yellow color of the tissues, while sulphuric acid will color them black. Taken internally diluted acids cause a feeling of constriction in the mouth and throat and roughness of the teeth. The secretion of saliva from parotid and sub-maxillary glands is stimulated. The alkaline intestinal secretions are promoted, while the acid secretions are checked by supplying acid artificially. If given before meals in small doses acidity of the stomach is decreased; in other words, it checks the acid gastric juices secretion by supplying it artificially, consequently if continued for some time they will cause irritation of the stomach and digestive trouble. They will check fermentation. Are astringent to tissues. Sulphuric acid is the strongest, while hydrochloric is the weakest astringent. Nitric acid is not as penetrating as other acids if applied locally. Acids should never be used when contraindicated.
In poisoning by these strong acids the destruction of tissue is so rapid that but little, as a rule, can be absorbed. The direct antidotes are alkalines to neutralize their action chemically. Stomach pump or tube is contra-indicated, as there is danger of perforation, which easily results, on account of the destruction of the walls of the passages to the stomach.
This is one of the strongest as well as most important acids. It fumes in the air, is very destructive to all organic matter, corrosive, dissolving many metals. It has a pungent odor and is very irritating to the respiratory organs. The acid, if pure, is colorless, if yellowish it shows that it contains impurities of iron or is old.
Toxic Effects: Pain throughout the digestive tract, vomiting, feeble pulse, clammy skin, collapse; eschars externally; yellow stains on clothing but none on the skin. This is a peculiarity of this acid if taken internally.
Acidum Hydrochloricum Dilutum:
Syn.—Hydrochloric acid dilute. Muriatic acid dilute.
As the pure hydrochloric acid is too strong for medical use, it is used in the diluted form, which is made by using 3 ounces of the pure concentrated acid with 7 ounces of pure water. Should be kept well corked. Of this dilution v to xx drops may be taken as a dose internally when indicated. Should it produce any disorder of the gastro-intestinal tract or colic it should not be used.
Properties: Restorative, antalkaline, antiseptic.
Indications: Deep red tongue and mucous membrane. Dry and cracked coat on the tongue; tongue contracted with brownish stripe in center. Sordes on the teeth. Digestion slow; pungent heat of skin; nervous prostration with other indications for this remedy.
Use: To correct undue alkalinity. Best to take through a glass tube to prevent its affecting the enamel of the teeth We find it often indicated in typhoid fever, tuberculosis of the lungs, catarrh or cancer of the stomach, neurasthenia, inflammatory conditions of typhoid form and low forms of fever. It will counteract phosphatic deposits in the urine. It is a good restorative and valuable remedy when indicated, but should be discontinued if the indications for its use have disappeared. Where there is undue alkalinity of the blood it is generally indicated, and, if so, should be used no matter what the disease. It is best to give it in the 2d to 3d homeopathic dilution.
It is a colorless liquid of a sour taste, very irritating odor, and has powerful corrosive action except on gold and platinum. It will turn the skin yellow, also wool fabrics. It is very powerful and should be used with care even if well diluted.
Indications: Tongue and mucous membrane bluish or violet color. Marked deficiency of secretion from mucous membrane and of the glandular structures with above indications. In all cases where acids are indicated with above indications nitric acid is of value.
Use: In gastro-intestinal troubles it may be given after meals; in cases where the uric acid and oxalic acids are excreted in abnormal quantities, with above indications, it has been recommended. The dose is 1 to 2 drops in 4 ounces of water; a teaspoonful 2 or 3 times a day. Some authorities claim that if taken internally diluted as above it will cure the tendency to formation of warts. Externally, in full strength, it may be applied to chancres and chancroids; it will destroy the specific poison and generally one application is sufficient. Care should be taken not to touch the adjoining healthy tissues with it. Nitric acid will readily coagulate tissue, but is less penetrating than most other acids.
Prepared by dissolving 6 1/2 % of the weight of sulphurous acid gas in 931/2 % of pure water.
Toxic effect: Black stains; pain throughout digestive tract; vomiting often of tarry matter; feeble pulse, clammy skin, profuse and bloody saliva.
Indications: In low forms of fever with feebleness and prostration. Tongue looks red, sleek or narrow and is dry and pointed, showing a want of tone of the stomach and a deficiency of acid generally in the system.
Use: In dyspepsia with vomiting of yeasty material intestinal dyspepsia with gas and flatulence and general deficiency of acid in the system; in pneumonia with purulent expectoration; bronchitis with fetid discharge; in diphtheria, and, in fact, any disease presenting above indications. In scabies, applied locally, it is even more prompt in action than sulphur.
Acidum Sulphuricum Aromaticum:
Synonym—Aromatic sulphuric acid. Elixir of vitriol.
Made by combining 3 3/4 fluid ounces of sulphuric acid, 15/8 fluid ounces of tincture of ginger, and alcohol a sufficient quantity to. make 33 3/4 fluid ounces. Keep well corked.
Indications for its use: Broad and full tongue, glutinous brown coat, viscid, sordes on teeth, tissues full and dirty looking. A raw beef tongue with mawkish odor of breath is also an indication.
It evaporates freely, melts at 249.8 F.; dissolves in 200 parts cold or 25 parts of boiling water; in 10 parts of glycerine. Very soluble in most essential oils, alcohol or ether.
Use: It neutralizes alkalinity in the body; lessens urea if given in large quantity, by appropriation of nitrogen, and does not dissolve uric acid as is generally believed. It is a good remedy in excessive secretion of phosphates. As its action is chemical it does not persist if its use is withdrawn. Incontinence of urine caused by irritation of the urine charged with gravel or by excessive alkalinity of the urine is cured by it. In cystitis, where there is ammoniacal urine it is a good remedy. In uremic poisoning it is one of our best remedies. While in some patients a fraction of a grain is sufficient others may require 2 to 3 grains as a dose. In all cases its effect should be watched and any marked cathartic effect avoided.
Other tomes: King's
Syn.—Boracic acid. Boric acid.
Physiological action: It is soluble in 3 parts of boiling water, almost entirely without taste, slightly acid and has a satin-like, pearly appearance. Taken internally in very large doses it will depress the heart and spinal nerve centers, causing a slow and feeble pulse, impaired respiration, nausea, vomiting, great depression of the mind, hiccough, stupor and coma. Eruption of the skin may also occur. In exceptional cases these symptoms more or less severe may occur if used locally as a dressing for wounds, etc. In these cases no doubt it is too easily absorbed and the patient too susceptible to its influence.
Use: It is a good antiseptic, although, as a germicide. its power is not very great. As a dressing for wounds and in surgical operations it is extensively used, being a clean, odorless, nonirritating and nontoxic dry dressing. We think of it in stomatitis and ulceration of the mouth as a wash. In cystitis a solution is very useful for irrigating the bladder. Of use in mild forms of conjunctivitis. As a dressing for carbuncles and boils it is better than a poultice. Locally applied in bromidrosis is assists the action of alteratives. Open abscesses or ulcers, after cleansing, may be dressed to advantage with boracic acid. In cervical leucorrhea, the result of excessive acid condition of the vagina, boracic acid applied dry to cervix and held there by a pledget of cotton, repeated every few days will cure in a very short time.
Other tomes: Potter
Is a useful antiseptic, antagonizes fermentation, putrefaction, micro-organisms; coagulates albumen. As we have, however, more powerful antiseptics that are less harmful to the tissues and less toxic in their effects the writer has little use for it. A general description of it, however is in place. Applied locally it causes irritation and burning, followed by an anesthetic effect. If applied longer it may cause sloughing, and, on account of its coagulating and constringent effects on tissues and the capillaries, gangrene may result. It often is absorbed when applied locally and thus systemic poisoning may result. If taken internally it causes burning, nausea, vomiting, scanty and smoky-colored urine, contracted pupils, cold skin, pallor, collapse and paralysis of respiration which results in death. If carbolic acid has been swallowed we can see the effects in white appearance of skin or the mucous membrane with which it has come in contact. Often we find that carbolic acid will not dissolve well in water, and especially in very cold water. If dissolved in glycerine first it will mix well with water. Say drachm 1 of carbolic acid to drachm 1 of glycerine is a good proportion; if then mixed with water it will readily dissolve.
As this acid is extremely powerful and, as we can well dispense with it in the practice of medicine it is not deemed necessary to give its therapeutic action. Therefore, the physiological action is only given to enable the reader to recognize its action in poisonous doses. In full poisonous doses it causes almost immediate death. The patient will gasp, become convulsed and die. Eyes are staring and open; teeth are clenched, froth appears at the mouth, face becomes purple and respiration will cease before the heart stops pulsating. The touch of the tongue to hydrocyanic acid often has produced immediate death by the powerful reflex irritation to the nerve centers in the medulla oblongata. In small but toxic doses heart action becomes slow, breathing becomes labored, mental disturbances take place, and there is a gradually increasing cyanotic appearance of the face. Nausea and vomiting often follow muscular spasms, spasmodic erection of the penis in the male, involuntary defecation, collapse and death. If life can be prolonged 25 minutes recovery may be possible as it is rapidly eliminated. Its paralyzing effect is on the nerve center in the medulla oblongata, manifesting itself first in the terminals or, in other words, in the peripheral nerves, and then in the muscles, showing its action on the spinal motor nerves. It stops the heart by irritation of the vagus root in the medulla oblongata and paralysis of the cardiac motor ganglia. If given in large medicinal doses it will cause anesthesia or paralysis of the nerve endings, headache, dizziness, vertigo, mind and nerve forces become impaired, temperature will fall, cyanotic appearance, palpitation of the heart, labored breathing which becomes shallow and rapid, cold perspiration and general muscular weakness follows.
Soluble in 450 parts of water, 14 parts of boiling water or 2% of alcohol. That which is produced from natural oil of wintergreen is the only kind that should be used for internal administration.
Physiological action: It will produce, in large doses, roaring in the head, flushed face, sometimes pressure in the head, fall of temperature and impaired reflex action. In very large doses it will increase above symptoms; pulse becomes very feeble, breathing more difficult, restlessness, delirium and even involuntary discharge of feces. It depresses the heart's action and function of the central nervous system, temperature sometimes falling way below normal. Destroys the red blood corpuscles, and, if continued for some time, will consequently impair the vital forces, cause general prostration, anemia and pallor. In the kidneys it may cause suppression of urine, temporary albuminuria and hematuria. The salicylate of sodium is milder in its effect and more soluble, and, for that reason, preferable in cases where indicated.
Use: As it is destructive to red blood corpuscles, depressing the heart's action, irritating the kidneys, sometimes producing congestion of same and hematuria, it should be used with care; should not be taken any length of time, and not in too large doses. It is contra-indicated when the tongue is red and pointed, showing irritation of the digestive tract.
We think of it in rheumatism and especially in the acute or subacute form, sciatica, locally in old, indolent ulcers, cold abscesses, cancer, corns, bunions, chilblains, and as a surgical dressing. As it prevents fermentation it may be used in fermentive dyspepsia, but as we have better and less irritating remedies for this trouble it is not to be recommended. To preserve fruit from fermentation it is used extensively. If urine is wanted for future analysis it will prevent it from fermenting. In fetid nasal catarrh it may be combined with nonirritating remedies, well diluted, and used with an atomizer.
The Materia Medica and Clinical Therapeutics, 1905, was written by Fred J. Petersen, M.D.