Kalium cyanatum

Volume I — Special Symptomatology

(Potasii Cyanidum.) Pharmacology. — This salt is prepared, according to the U. S. pharmacopoeia, by heating together the ferrocyanide of Potassium and the Carbonate of Potassium. It occurs in white, amorphous, opaque masses, having the odor of Prussic acid and a taste of similar character, but somewhat alkaline.

It is deliquescent, and readily soluble in water. When the Nitrate of Silver is added to its solution, there falls a precipitate of the Cyanide of Silver, which is wholly soluble in ammonia.

Officinal Preparations. — Mother Tincture; one grain to ten grains of distilled water; dilutions to the 3d x with water, higher with strong alcohol.

Analogues. — Acidum hydrocyanicum, Amygdala amara, Prunus, Laurocerasus, Digitalis.

[A most violent poison, very similar in action to Hydrocyanic acid. Three grains are sufficient to destroy life.]

Sensorium.

Sudden loss of consciousness.

Head.

Severe, sudden pain in the head.

"Vertigo, and sensation of weight in the head.

Great pain in back part of the head.

"Torturing neuralgic headache in orbital and supra-maxillary region ; the pains recurring daily at the same hour, with much flushing of that side of the face.

0 Agonizing attacks of neuralgic pains between the temporal region and ciliary arch and maxilla, with screams and apparent loss of sensibility, as if struck with apoplexy; pulse, eighty-four; face flushed.

° Severe neuralgic pains in temporal region and left upper jaw, daily at 4 a. m., increasing till 10 a. m., and ceasing at 4 p. m. ; in the interval anorexia, fever, headache, etc.

0 In headaches depending on dyspepsia, imperfect menstruation, known as "sick-headache," the external application of a solution, not stronger than two or four grains to one ounce of water, applied on compresses, will give prompt relief. (Trousseau.)

Face, Eyes and Ears.

Face flushed, with neuralgic headache.

Eyes fixed, pupils dilated; dim vision.

Ears, rushing sound in the ears.

Gastric.

Sense of constriction in the throat. Intense burning in the stomach.

Nausea, with sense of choking when trying to swallow fluids,

followed by copious vomiting. A feeling as if the bowels were about to act.

Chest.

He cannot take a deep inspiration, but has no definite pain.

Respiration slow and difficult. Abdominal respiration (in animals).

° Troublesome cough, preventing sleep at night, with dullness on percussion; respiration feeble, mixed with crepitant and bronchial rales.

Heart.

It paralyses the heart in tetanic spasm; general convulsive action of the whole body ten minutes after the heart ceased to beat.

Trunk and Extremities.

Spasmodic tetanic stiffness of trunk and limbs, with shuddering of the limbs.

Skin about the joints fissured, with oozing of blood; the inflammation extending to the nail and its root.

Ulceration of the soft parts of the hands down to the bone, with great pain.

Generalities.

She fell as if struck by lightning, and died in forty minutes;

(from twelve grains). General convulsions; eyes fixed and limbs contracted. ° Acute articular rheumatism.

Volume II — Special Therapeutics

This drug, sometimes called the Cyanuret of potassium, is one of the most violent poisons known. Its action is very similar to Hydrocyanic acid. Its analogues are Prunus, Lycopus, Laurocerasus, Digitalis, and Amygdala. Three grains are sufficient to destroy life in a human adult.

Allopathic physicians are very cautious how they use this medicine. Their utter disbelief in the value of inappreciable doses unfits them for the selection and administration of such agents.

The poisonous effects of this salt do not differ essentially from the acid. It has been proved by numerous experiments that the latter “acts through the blood , directly upon the cerebral and spinal centres, and indirectly upon the lungs and heart, probably first suspending respiration through the want of the proper nervous influence to the pulmonary function ; and secondly, arresting the heart’s action through the want of blood from the lungs. Death, therefore, takes place through asphyxia. Hence the general venous congestion observed after death, affecting the brain, lungs, etc. The insensibility, however, is the antecedent of the asphyxia, and depends not upon the want of blood in the brain, but upon the immediate paralyzing influence of the poison.”

I do not see why it may not paralyze the heart , directly, as "well as the brain ; but some facts seem to point to the contrary, for it is asserted that u the heart continues to beat after respiration has ceased.”

Prescribed according to the law of similia, it can be used in all cases where the provings of the acid show that it is indicated, for its union with Potassium does not effect any change in that respect, although we may get additional symptoms belonging to the alkali.

The keynote, or characteristic primary condition or symptom indicating the Cyanide is the suddenness and severity of the attacks.

A woman who took 12 grains fell as if struck by lightning, and died in 40 minutes. In fatal poisoning by the Hydrocyanic acid, death has occurred in less than a minute.

I believe that you will find it useful in those rare cases of cerebro-spinal congestion which have been known to throw the victim into fatal or dangerous coma in less than half an hour; or in cases of apoplexy from venous congestion, striking the patient down with equal suddenness.

We find recorded among its symptoms “ severe sudden pain in the head, vertigo, and sensation of weight and great pain in the back of the head.”

It has cured some very intense periodic neuralgias , viz.:

(1.) Torturing neuralgic headache in orbital and supramaxillary region ; the pains recurring daily at the same hour, with much flushing of that side of the face.

(2.) Agonizing attacks of neuralgic pains between the temporal region, ciliary arch, and maxillary, with screams and apparent loss of sensibility, as if struck with apoplexy; pulse 84, face flushed.

(3.) Severe neuralgic pains in temporal region and left upper jaw, daily at 4 P.M., increasing till 10 A.M., and ceasing at 4 p.m.; in the interval, anorexia, fever, headache, etc. Similar cases have been cured by Arsenic, Quinine, Atropia, Chelidonium, and Nux vomica, but the diagnostic difference in favor of the Cyanide is the suddenness and severity of the paroxysm.

The dose in such cases (or in any case) should not exceed the 1st centesimal trituration, in a one-grain dose, repeated every hour

or two in the apyrexia, and every fifteen minutes during the paroxysm. Allopathists direct the maximum dose to be one-eighth of a grain. The or ^ would be safe for an adult. A dilution containing T-fru grain to a drop makes an eligible preparation, as the 2° or 3° could be used for children.

It has been used externally for the relief of headaches. Trousseau directs a solution not stronger than two to four grains to an ounce of water, but I cannot recommend it, except as a last resort in the most severe cases.

It seems indicated in spasmodic affections of the oesophagus, followed by vomiting from paralysis of that tube, as witness the symptom :

“Nausea, with sense of choking when trying to swallow fluids, followed by copious vomiting.”

I think it will prove valuable in gastritis of very sudden onset and severe character.

It corresponds to threatened asphyxia from venous congestion of the lungs; also, to whooping-cough, when asphyxia occurs during the severe paroxysms. You may find it useful in some cases of nightly cough of a paroxysmal character, even when caused by cardiac disease.

I have prescribed it a few times in functional disorder of the heart, with slow, feeble, irregular pulse, alternating with palpitations. Even if the cardiac disease is organic, and the nervous element largely predominates, it will be found useful. A tendency to venous congestion, and a bluish color of the lips and skin, are specific indications.