Alumen

Volume I — Main text

^^P ALUMEN.

^^m Alum, PotasstcAlumimc sutphnte. K3Al24S04,%4HjO.

L Frovings, — I. Dr. Jeanes took 3rd cent. trit. (how is not stated). On 8th d. had bruised feeling on lower edge of I orbit, on pressure or on moving lids, lasting 2 d, ; and piles, with aching within anus. On nth d., three yellow diarrhceic stools, like an infant's, (Hering, Mat. Mtd.^ vol. i, 1873.)

2* N. N — took 5 daily doses of same, — ist 3 in e., 4th and 5th in m. After 1st dose, slept well ^ in m., 1 h. after rising, weariness, and for 3 h, twitching in limbs, particularly rn arms, — therewith much excited. In \ h. after 2nd dose felt very warm in 1. side, opposite shoulder, internally, and also very tired ; but slept well. Same sensation at same interval after 3rd dose ; n. again good ; in m. some headache over eyes, and pain in I. chest. After 4th dose, very soon tired j warm ebullitions like spasms spread over whole trunk, particularly back ; no pains, but trembling of muscles ; towards 2 o'clock pains if chest return, better when walking. In 15 m. after 5th dose a kind of cramp in back just below hips on both sides j very warm ebullitions \ the sensation went from the hips up the 1. side ; it so frightened him that he took a cup of coffee to remove it. {Ibid,)

3, Dr. Rhees proved same {manner unknown). In i h* after 2nd dose had rheumatic pains in arms and chest, and over I. eye, Othcc symptoms are not dated : they are — Pain in head, coming and going^^^ from place to place ; sensation of fulness in chest, also in arms (especially after supper) ; stitching pain down middle of chest, later in r. side ; severe pain in 1. shoulder ; pain in n arm as if a string were tied tightly round it ; bruised pains in joints of arms, hands and feet ; rheumatic pain in 1. hand and all finger-joints ; pain in both knees, particularly in r., when walking j uneasiness in knees, with pain just above them j rheumatic, and bruised, pain in whole body ; sensation, all forenoon, of inward heat. {Ibid.)

4, — a. Miss R. A. Rhees took 6ch dil (manner not stated, but evidently in repeated doses). Her symptoms were — Dull heavy pain in head, particularly in back part ; in 3rd week unusually good appetite and thirst, on 21st d. little appetite ; after a meal, heaviness in stomach and throbbing as in an abscess, also distension at epigastrium \ 2 h*

• Dr. Rutherford, in his recent experiments on dogs, found A. an undoubted cholagogue. — EPS,

^33

after taking it in m., seized with nausea, faintncss and weakness, lasting till afternoon, when pain returned ^ with nausea, nervous restlessness and excitement, mental rather than bodily ; on another occasion nausea and faint ness, accompanied with sick, griping pain in stomach and loathing of food j on 22nd d. nausea in m., and so weak that she could not sit up, felt a heat in stomach with great thirst, relieved by drinking cold water j at 1 1 a.m. sinking sensation at stomach, after eating something she fek stronger, but had far 15 m. a violent throbbing there, extending to heart, and violent palpitation ; for several weeks after proving distension at epigastrium after eating ; soon after taking it in e., felt a slight pain or binding sensation in her breast, especially on r. side, which disappeared on (almost immediately) retiring to rest.

Besides these symptoms, Miss R, had two singular attacks while taking drug, which she thus describes :

h, " Between 3 and 4 p.m. I felt a pain in my r. arm as though a cord were drawn tightly round it, just below shoulder, occasioning great fulness of blood-vessels and deprivation of strength. The pain was dull and heavy, not general throughout the arm, but rather in lines extending in different directions from the ligature which apparently bound it ; the weakness was such that 1 could not hold the needle which 1 was using when the pain commenced. The attaclc began suddenly, continued for a few moments, and then abated j though it did not leave me entirely, and returned at regular intervals during remainder of d. and e. Renewed doses increased pain in arm, which is this e. quite severe/* Writing apparently of and at same time, she describes a " sensation as if a cord were tied around the leg, under r. knee j pain extends downward and upward, but is confined to lower leg. To-night a similar feeling, though much slighter ; the pain is on the under part of the limb only."

€, On sth d,, about 3,45 p.m., sitting in church, was seized with a sharp, steady pain in the stomach, accompanied with the most deathlike faintness she ever remembered to have felt, with extreme sickness and immediate loss of strength. A cold sweat covered her, she thinks she must have been deathly pale, for she felt as though the blood (which had at first been driven to the head by the suddenness and severity of the pain) were leaving it and the extremities altogether i they were quite cold ; her sight grew dim, and she became so faint that she expected every moment to fall from her seat* The pain in stomach felt as though it would draw her double. The attack lasted, she thinks, about I h., after which violence of pain gradually abated, faintness passed off, chilliness gave place to heat, and the blood rushed to her head with such a force that she could hardly hold it up, or keep her eyes open, though quite conscious of what was going on about her. After service, she was able to walk slowly home, though very weak, feeling very much as if she had been ill for a month. She felt the weakness especially in her back, although she had no pain there ; but during rest of e., whenever drawing a long breath, it appeared to come from a spot on each side of spine, about middle of back, on h'ne with inferior angles of scapula. Effects passed off with night's rest, and there was no return of symptoms. [Itid,)

1. Miss Alic£ Rhees^ a younger sister of above, commenced proving same dilution, but next d, had similar attack at noon. Was seized instantaneously with most acute pain in stomach ; was found sitting drawn together, with knees against breast and face h'kc a corpse, deathly pale, lips blue. Chamomilla relieved, but there remained great vertigo and nausea ; she complained of being very cold, but did not shudder; great weakness, as after long illness, with headache lasting all afternoon. (Ibid,)

2. Mrs. Rhees experienced similar symptoms from the 12th, of which she took repeated doses. The attack occurred on two successive m., about l h. after rising \ istd. pain was absent, but nausea, faintness and coldness were very pronounced, and d. pain was severe. Dr. HusEMANN also, while taking same potency, twice had sudden sharp pain in region of stomach. (Ibid,)

3. Tn, friend of Dr. Husemann, took 6th on May nth and izth. On m^ of 1 2th and 13th, woke with pressing headache over eyes, which lasted till 10 a,m», relieved by drinking cold water; about 9.30 p,m. same headache, with vertigo, lasting till bedtime, lessening after lying down to sleep. Also un both mornings, while washing and dressing, pains in 1. chest, near middle of sternum, lasting till 9 a.m. He also had tickling in larynx, causing cough j tongue rough, and as if scraped^ in m. ; lassitude in whole body, especially in 1. leg j very light and restless sleep. On 3rd d., in m, on rising, he spat a lump of coagulated blood. (Uid.)

4. Barthez took, fasting, 5SS of alum in Jj of water. Immediately contraction in whole mouth, lasting ^ h., with very painful pressure in stomach. During rest of d. no marked symptoms. After 3 d. took 3J in ^ij water. This was followed by more violent contraction than before ; appetite was not diminished, but on the contrary he thought it improved, and digestion rather better than usual. After this took doses increasing every time by 5SS, till he took 3iiss at once. Thereupon he experienced violent urgency to vomit, lasting nearly ^ h., but without vomiting. Throughout d. no marked disturbance.

The inclination to vomit seemed to depend rather on the astringency and disagreeable taste of drug than upon any irritating influence on stomach. After 6 d. took ^ting 5iij at a dose, and in 3 or 4. m. vomited twice a portion of solution. Through d, no symptoms of any kind ; only 2 or 3 d. after stools were more difficult than usuaL The vomiting spoken of occurred without effort and without previous nausea. {Ricueil da Mem, di Med,, 1835.)

1. WtBMfiR, in experiments on self with alum in doses of gr. iij in jv of water, taken several times a day, observed dryness of mouth and throat, thirst, diminished frequency and increased consistency of stools. [JVirkung^ kc,^ I, 114.)

2. In the experience of Begin, and also of Barbier, the long-continued use of small doses of alum produces cough in persons with sensitivc bronchial tubes.* (Lewin, Op, at,, p. 51.)

• Prover No. 6 (but no other) experienced hoarseness, and evea loss of voice, with tickling cough on talking.— £Dt.

^35

1. A. W— , health sound, pulse 65, regular, took 10 gr. of t^ at 6 a«m. Soon^ watery eyes, followed by sneezing. At 6,10 tasteless eructations and shifting flatulence. 6.15, drawing in plantar surface of r. foot, afterwards in epigastrium, 7.0, free and watery urine (had been relieved at 5.30). 730, cramp-like drawing and stiffness in cervical region. 8.0^ discharge from eyes has become glutinous and annoyine ; occasional wandering cramps 8,30, urination as before ; pulse 70, 9,0, no appetite for delayed breakfast ; slight irritative cough. 9«4-5, urging to stool with much borborygmus j ringing in r, ear; cough while exercising. lo.o, burning and itching in r. outer canthus. JO. 35, urging to urinate, 1 130, easy fatigue from short walk^ followed by backache in lumbar region ; pulse 86, 12.45) f^^^^ as from hunger ; palpitation ; much abdominal flatus. 2.0, languor and headache; voice uncertain; nostrils and mouth dry; no thirst

*30, loose stool^ much flatus ; ha?morrhoidal irritation followed. Was constipated for 2 d, afterwards ; urine was scant and high coloured. "(Woodward, Mi^d. Era^ Jan., 1885 )

12, The received theory of the action of alum is that it causes a contraction of the blood-vessels ; but we have failed in most cases to see any evident alteration, as ascertained by direct measurements on the mesentery of the frog, in the size of the blood-vessels when alum solutions were dropped upon them. In a few cases an expansion, and in two only a slight contraction, was noticed ; the capillaries themselves were generally expanded. Nevertheless, a stasis in the circulation often occurred, (Nothnagel and Rossbach, Ar^mtmiUelUhri^ sub voce.)

11, Pmmings. — i. a. The reaction of A. with albumen furnishes a simple explanation of the corrosive action of the salt in solid form or in concentrated solution. The great rapidity with which a case observed by Ricquet {Journ, de Pharm, it Chim.^ Oct,, 1873) proved fatal], and some symptoms noted in previous cases of poisoning (tremor of muscles, spasms, depression, &c,) give reason to suspect that A. exerts also a constitutional action, the more so as in Ricquet's case the local lesions were found at the autopsy comparatively slight, and entirely out of proportion to the rapid course of the poisoning.

b. Of all the symptoms the most constant are the pains in the cavity of the mouth, oesophagus and stomach, which are experienced immediately after taking the poison, and also the vomiting, which comes on very soon, and is sometimes bloody, Ricquet also observed severe dysphagia, torturing thirst, and retention of faeces. Several writers mention great weakness of the muscles and depression. The consciousness is unclouded. There is great anxiety, and sometimes a convulsive tremor of the muscles is observed. The pulse is exceedingly small and frequent. After repeated fainting fits and a considerable reduction of temperature below the normal point, death ensued within

£, At the autopsy, yellowish-grey deposits were found on the mucous membrane of mouth, pharynx, and oesophagus ; tongue and palate were swollen. Stomach, intestines, and kidneys were hypersemic, but without noticeable loss of substance. (Boehm, Ziimssin's CycL^ xvii.)

III. Experiments on animals. — I. a» Orfila gave 3vij of crystallised lum in powder to dogs ; the animals retained it from lo — 30 ra,, then Ifomited, and in an h. were apparently well ; gij of burnt alum in ^iv of cold water occasioned vomiting only. When oesophagus was tied to prevent vomiting death took place in 5 h,, with symptoms of great exhaustion and diminished sensibiHty. On P.M» examination, mucous membrane of stomach was found inflamed in whole extent.

if, Bourgelat has seen a phthisical condition induced in horset by the use of alum in too great quantities. (Pereira, op> dt.^ sub voce,)