Zoonomia Volume Ii Part 73

Does it chemically destroy the stomach, and life in consequence? or does it destroy the action of the stomach by its great stimulus, and life in consequence of the sympathy between the stomach and the heart? This last appears to be the most probable mode of its operation.

The success of a.r.s.enic in the cure of intermittent fevers I suspect to depend on its stimulating the stomach into stronger action, and thus, by the a.s.sociation of this viscus with the heart and arteries, preventing the torpor of any part of the sanguiferous system. I was led to this conclusion from the following considerations.

First. The effects of a.r.s.enic given a long time internally in small doses, or when used in larger quant.i.ties externally, seem to be similar to those of other great stimuli, as of wine or alcohol. These are a bloated countenance, swelled legs, hepatic tumours, and dropsy, and sometimes eruptions on the skin. The former of these I have seen, where a.r.s.enic has been used externally for curing the itch; and the latter appears on evidence in the famous trial of Miss Blandy at Chelmsford, about forty years ago.

Secondly. I saw an ague cured by a.r.s.enic in a child, who had in vain previously taken a very large quant.i.ty of bark with great regularity. And another case of a young officer, who had lived intemperately, and laboured under an intermittent fever, and had taken the bark repeatedly in considerable quant.i.ties, with a grain of opium at night, and though the paroxysms had been thrice thus for a time prevented, they recurred in about a week. On taking five drops of a saturated solution of a.r.s.enic thrice a day the paroxysms ceased, and returned no more, and at the same time his appet.i.te became much improved.

Thirdly. A gentleman about 65 years of age had for about ten years been subject to an intermittent pulse, and to frequent palpitations of his heart. Lately the palpitations seemed to observe irregular periods, but the intermission of every third or fourth pulsation was almost perpetual. On giving him four drops of a saturated solution of a.r.s.enic from a two-ounce phial about every four hours for one day, not only the palpitation did not return, but the intermission ceased entirely, and did not return so long as he took the medicine, which was three or four days.

Now as when the stomach has its action much weakened by an over-dose of digitalis, the pulse is liable to intermit, this evinces a direct sympathy between these parts of the system, and as I have repeatedly observed, that when the pulse begins to intermit in elderly people, that an eructation from the stomach, voluntarily produced, will prevent the threatened stop of the heart; I am induced to think, that the torpid state of the stomach, at the instant of the production of air occasioned by its weak action, caused the intermission of the pulse. And that a.r.s.enic in this case, as well as in the cases of agues above mentioned, produced its effects by stimulating the stomach into more powerful action; and that the equality of the motions of the heart was thus restored by increasing the excitement of the sensorial power of a.s.sociation. See Sect. XXV. 17. Cla.s.s IV. 2. 1. 18.

10. Where a.r.s.enic has been given as a poison, it may be discovered in the contents of the stomach by the smell like garlic, when a few grains of it are thrown on a red-hot iron. 2. If a few grains are placed between two plates of copper, and subjected to a red heat, the copper becomes whitened.

3. Dissolve a.r.s.enic in water along with vegetable alcali, add to this a solution of blue vitriol in water, and the mixture becomes of a fine green, which gradually precipitates, as discovered by Bergman. 4. Where the quant.i.ty is sufficient, some wheat may be steeped in a solution of it, which given to sparrows or chickens will destroy them.

VII. Absorption of the matter from venereal ulcers. No ulcer can heal, unless the absorption from it is as great as the deposition in it. The preparations or oxydes of mercury in the cure of the venereal disease seem to act by their increasing the absorption of the matter in the ulcers it occasions; and that whether they are taken into the stomach, or applied on the skin, or on the surface of the ulcers. And this in the same manner as sugar of lead, or other metallic oxydes, promote so rapidly the healing of other ulcers by their external application; and probably when taken internally, as rust of iron given to children affected with scrophulous ulcers contributes to heal them, and solutions of lead were once famous in phthisis.

The matter deposited in large abscesses does not occasion hectic fever, till it has become oxygenated by being exposed to the open air, or to the air through a moist membrane; the same seems to happen to other kinds of matter, which produce fever, or which occasion spreading ulcers, and are thence termed contagious. See Cla.s.s II. 1. 3. II. 1. 5. II. 1. 6. 6. This may perhaps occur from these matters not being generally absorbed, till they become oxygenated; and that it is the stimulus of the acid thus formed by their union with oxygen, which occasions their absorption into the circulation, and the fever, which they then produce. For though collections of matter, and milk, and mucus, are sometimes suddenly absorbed during the action of emetics or in sea-sickness, they are probably eliminated from the body without entering the circulation; that is, they are taken up by the increased action of one lymphatic branch, and evacuated by the inverted action of some other lymphatic branch, and thus carried off by stool or urine.

But as the matter in large abscesses is in general not absorbed, till it becomes by some means exposed to air, there is reason to conclude, that the stimulus of this new combination of the matter with oxygen occasions its absorption; and that hence the absorption of matter in ulcers of all kinds, is still more powerfully effected by the external application or internal use of metallic oxydes; which are also acids consisting of the metal united with oxygen; and lastly, because venereal ulcers, and those of itch, and tinea, will not heal without some stimulant application; that is, the secretion of matter in them continues to be greater, than the absorption of it; and the ulcers at the same time continue to enlarge, by the contagion affecting the edges of them; that is, by the stimulus of the oxygenated matter stimulating the capillary vessels in its vicinity into actions similar to those of the ulcer, which produces it.

This effect of the oxydes of mercury occurs, whether salivation attends its use or not. Salivation is much forwarded by external warmth, when mercury is given to promote this secretion; but as the cure of venereal complaints depends on its absorbent quality, the act of salivation is not necessary or useful. A quarter of a grain of good corrosive sublimate twice a day will seldom fail of curing the most confirmed pox; and will as seldom salivate, if the patient be kept cool. A quarter of a grain thrice a day I believe to be infallible, if it be good sublimate.

Mercury alone when swallowed does not act beyond the intestines, its active preparations are the salts formed by its union with the various acids, as mentioned in the catalogue. Its union with the vegetable acid, when triturated with manna, is said to compose Keyser's Pill. Triturated with gum arabic it is much recommended by Plenk; and triturated with sugar and a little essential oil, as directed in a former Edinburgh Dispensatory, it probably forms some of the syrups sold as nostrums.

United with sulphur it seldom enters the circulation, as when cinnabar, or aethiop's mineral, are taken inwardly. But united with fat and rubbed on the skin, it is readily absorbed. I know not whether it can be united to charcoal, nor whether it has been given internally when united with animal fat.

VIII. 1. Absorptions in general are increased by inanition; hence the use of evacuations in the cure of ulcers. Dr. Jurin absorbed in one night, after a day's abstinence and exercise, eighteen ounces from the atmosphere in his chamber; and every one must have observed, how soon his sheets became dry, after having been moistened by sweat, if he throws off part of the bed-clothes to cool himself; which is owing to the increased cutaneous absorption after the evacuation by previous sweat.

2. Now as opium is an universal stimulant, as explained in the article on Incitantia, it must stimulate into increased action both the secretory system, and the absorbent one; but after repeated evacuation by venesection, and cathartics, the absorbent system is already inclined to act more powerfully; as the blood-vessels being less distended, there is less resistance to the progress of the absorbed fluids into them. Hence after evacuations opium promotes absorption, if given in small doses, much more than it promotes secretion; and is thus eminently of service at the end of inflammations, as in pleurisy, or peripneumony, in the dose of four or five drops of the tincture, given before the access of the evening paroxysm; which I have seen succeed even when the risus sardonicus has existed. Some convulsions may originate in the want of the absorption of some acrid secretion, which occasions pain; hence these diseases are so much more certainly relieved by opium after venesection or other evacuations.

IX. 1. Absorption is increased by the calces or solutions of mercury, lead, zinc, copper, iron, externally applied; and by a.r.s.enic, and by sulphur, and by the application of bitter vegetables in fine powder. Thus an ointment consisting of mercury and hog's fat rubbed on the skin cures venereal ulcers; and many kinds of herpetic eruptions are removed by an ointment consisting of 60 grains of white precipitate of mercury and an ounce of hog's fat.

2. The tumours about the necks of young people are often produced by the absorption of a saline or acrid material, which has been deposited from eruptions behind the ears, owing to deficient absorption in the surface of the ulcer, but which on running down on the skin below becomes absorbed, and swells the lymphatic glands of the neck; as the variolous matter, when inserted into the arm, swells the gland of the axilla. Sometimes the perspirative matter produced behind the ears becomes putrid from the want of daily was.h.i.+ng them, and may also cause by its absorption the tumours of the lymphatics of the neck. In the former case the application of a cerate of lapis calaminaris, or of cerussa applied in dry powder, or of rags dipped in a solution of sugar of lead, increases the absorption in the ulcers, and prevents the effusion of the saline part of the secreted material. The latter is to be prevented by cleanliness.

After the eruptions or ulcers are healed a solution of corrosive sublimate of one grain to an ounce of water applied for some weeks behind the ear, and amongst the roots of the hair on one side of the head, where the mouths of the lymphatics of the neck open themselves, frequently removes these tumours.

3. Linen rags moistened with a solution of half an ounce of sugar of lead to a pint of water applied on the erysipelas on anasarcous legs, which have a tendency to mortification, is more efficacious than other applications.

White vitriol six grains dissolved in one ounce of rose-water removes inflammations of the eyes after evacuation more certainly than solutions of lead. Blue vitriol two or three grains dissolved in an ounce of water cures ulcers in the mouth, and other mucous membranes, and a solution of a.r.s.enic externally applied cures the itch, but requires great caution in the use of it. See Cla.s.s II. 1. 5. 6.

4. Bitter vegetables, as the Peruvian bark, quilted between two s.h.i.+rts, or strewed in their beds, will cure the ague in children sometimes. Iron in solution, and some bitter extract, as in the form of ink, will cure one kind of herpes called the ringworm. And I have seen seven parts of bark in fine powder mixed with one part of ceruss, or white lead, in fine powder, applied dry to scrophulous ulcers, and renewed daily, with great advantage.

5. To these should be added electric sparks and shocks, which promote the absorption of the vessels in inflamed eyes of scrophulous children; and disperse, or bring to suppuration, scrophulous tumours about the neck. For this last purpose smart shocks should be pa.s.sed through the tumours only, by inclosing them between two bra.s.s k.n.o.bs communicating with the external and internal coating of a charged phial. See Art. II. 2. 2. 2.

X. 1. Bandages increase absorption, if they are made to fit nicely on the part; for which purpose it is necessary to spread some moderately adhesive plaster on the bandage, and to cut it into tails, or into shreds two inches wide; the ends are to be wrapped over each other; and it must be applied when the part is least tumid, as in the morning before the patient rises, if on the lower extremities. The emplastrum de minio made to cover the whole of a swelled leg in this manner, whether the swelling is hard, which is usually termed s...o...b..tic; or more easily compressible, as in anasarca, reduces the limb in two or three days to its natural size; for this purpose I have sometimes used carpenter's glue, mixed with one twentieth part of honey to prevent its becoming too hard, instead of a resinous plaster; but the minium plaster of the shops is in general to be preferred. Nothing so much facilitates the cure of ulcers in the legs, as covering the whole limb from the toes to the knee with such a plaster-bandage; which increases the power of absorption in the surface of the sore.

2. The lymph is carried along the absorbent vessels, which are replete with valves, by the intermitted pressure of the arteries in their neighbourhood.

Now if the external skin of the limb be lax, it rises, and gives way to the pressure of the arteries at every pulsation; and thence the lymphatic vessels are subject to the pressure of but half the arterial force. But when the external skin is tightened by the surrounding bandage, and thence is not elevated by the arterial diastole, the whole of this power is exerted in compressing the lymphatic vessels, and carrying on the lymph already absorbed; and thence the absorbent power is so amazingly increased by bandage nicely applied. Pains are sometimes left in the fleshy parts of the thighs or arms, after the inflammation is gone, in the acute rheumatism, or after the patient is too weak for further evacuation; in this case after internal absorbent medicines, as the bark, and opiates, have been used in vain, I have successfully applied a plaster-bandage, as above described, so as to compress the pained part.

XI. 1. We shall conclude by observing, that the sorbentia strengthen the whole habit by preventing the escape of the fluid part of the secretions out of the body, before it has given up as much nourishment, as it is capable; as the liquid part of the secretion of urine, sweat, saliva, and of all other secretions, which are poured into receptacles. Hence they have been said to brace the body, and been called tonics, which are mechanical terms not applicable to the living bodies of animals; as explained in Sect.

x.x.xII. 3. 2.

2. A continued use of bitter medicines for years together, as of Portland's powder, or of the bark, is supposed to induce apoplexy, or other fatal diseases. Two cases of this kind have fallen under my observation; the patients were both rather intemperate in respect to the use of fermented liquors, and one of them had been previously subject to the gout. As I believe the gout generally originates from a torpor of the liver, which instead of being succeeded by an inflammation of it, is succeeded by an inflammation of some of the joints; or by a pimpled face, which is another mode, by which the disease of the liver is terminated. I conceive, that the daily use of bitter medicine had in these patients prevented the removal of a gouty inflammation from the liver to the membranes of the joints of the extremities, or to the skin of the face, by preventing the necessary torpor of these parts previous to the inflammation of them; in the same manner as cold fits of fever are prevented by the same medicines; and, as I believe, the returns of the gout have sometimes for two or three years been prevented by them.

One of these patients died of the apoplexy in a few hours; and the other of an inflammation of the liver, which I believe was called the gout, and in consequence was not treated by venesection, and other evacuations. From hence it appears, that the daily use of hop in our malt liquor must add to the noxious quality of the spirit in it, when taken to excess, and contribute to the production of apoplexy, or inflammation of the liver.

III. CATALOGUE OF THE SORBENTIA.

I. Sorbentia affecting the skin.

1. Acid of vitriol, of sea-salt, lemons, sloes, prunus spinosa, crabs, pyrus, quince, pyrus cydonia, opium.

2. Externally calx of zinc, of lead, of mercury.

II. Sorbentia affecting the mucous membranes.

1. Juice of sloes, crabs, Peruvian bark, cinchona, opium.

2. Externally blue vitriol.

III. Sorbentia affecting the cellular membrane.

1. Peruvian bark, wormwoods, artemisia maritima, artemisia absynthium, worm-seed, artemisia santonic.u.m, chamomile, anthemis n.o.bilis, tansey tanacetum, bogbean, menyanthes trifoliata, centaury, gentiana centaurium, gentian, gentiana lutea, artichoke-leaves, cynara scolymus, hop, humulus lupulus.

2. Orange-peel, cinnamon, nutmeg, mace.

3. Vomits, squill, digitalis, tobacco.

4. Bath of warm air, of steam.

IV. Sorbentia affecting the veins.

1. Water-cress, sisymbrium nasturtium aquatic.u.m, mustard, sinapis, scurvy-gra.s.s cochlearia hortensis, horse-radish cochlearia armoracia, cuckoo-flower, cardamine, dog's-gra.s.s, dandelion, leontodon taraxacon, cellery apium, cabbage bra.s.sica.

2. Chalybeates, bitters, and opium, after sufficient evacuation.

3. Externally vinegar, friction, electricity.

V. Sorbentia affecting the intestines.

1. Rhubarb, rheum palmatum, oak-galls, gallae quercinae, tormentil, tormentilla erecta, cinquefoil potentilla, red-roses, uva ursi, simarouba.

2. Logwood, haematoxylum campechianum, succus acaciae, dragon's blood, terra j.a.ponica, mimosa catechu.

3. Alum, earth of alum, Armenian bole, chalk, creta, crab's claws, chelae cancrorum, white clay, cimolia, calcined hartshorn, cornu cervi calcinatum, bone-ashes.

VI. Sorbentia affecting the liver, stomach, and other viscera. Rust of iron, filings of iron, salt of steel, sal martis, blue vitriol, white vitriol, calomel, emetic tartar, sugar of lead, white a.r.s.enic.

VII. Sorbentia affecting venereal ulcers. Mercury dissolved or corroded by the following acids: