Lacticum acidum

Volume I — Main text

ACIDUM LACTICUM.

Lactic acid, HC,H^O,. Result of fermentation of sugar of mift.

I. Proviftgs, — I. F. R. took several doses of ist dil. Experienced on]y tense of fulness in forehead, as if brain were too large, during d. ; ana in e. therewith tliglit headache, a dull pain on both sides of forehead.

a. on two occasions took same. On both had much nausea, persiitiiiK for

days. On first also diarrhoeic stool, causing hurrying; and Mireness to touch Uong r. sciatic nerve, on getting out of bed, lasting all day, and pulsating constantly but slightly. On second pupils were dilated; tongue sore on 1. side, raw and red| rheumatic pains affected both shoulders, running up muscles of neck to mastoid processes, and into ears $ and there was sensation as if feet were perspiring copiouily.

• *' We consider the convulsions of prussic acid poisoning as the expression of a transient but energetic irritation of the central apparatus of the brain and cord."

1. S. took one doK of ix dil. His symptom* were: mouth constantly full of water, worse after each eructation i saliva salt, like brine, for several d. ; hilnew of fauces, with intent burning in throat, fauces, and oesophagus, in latter especially after eructation, which caused also qualmy feeling; the eructations were frequent, burning hot gas or acrid fluid coming up, and spaimodic ringing cough r«ulting from the irritation produced. There was burning and weight in the stomach, aggravated by tobaccO) ai were also the eructations, (T. F. Allen, M Tork Journ. of Horn,, i.)

II, Fmomngs. — 1. A man, act. 51, suffering from diabetes, never had rheumatism. Lung symptoms manifesting themselves. On March 8th took as medicine 15 m of I. acid 4 times in d. On 9th took y> v\ in m. In afternoon bad acute pains in jomts and fiying pains about limbs. In c, pains increased ; medicine discontinued. 10th. — No medicine« Pains gradually ceai>ed, nth. — Repeat acid 15 })\ ter die. I2th, c., pain in joints. 13th, m., small joints of fingers of both hands, wrists, and in less degree elbows, were noted as being red, swollen, and painful. E,, small joint*^ of fingers, both wrists, and elbows, all red, hot^ swollen, tender, painful. Heart-ounds clear. Temp., m, 100^ F., c, 101° F. Pulse 90, soft and full. Moderate perspiration. Discontinue 1. acid. 14th, m., decided improvement in all joints. Swelling le^s, heat and pain still present. T. 100^, P. 84* E. All joints of fingers much better^ wrists still affected. Good deal of pam in knees, which had hitherto escaped, T. ioog° P. 90. 15th, m. T* 986°, e, T, 994^ Joints better, i6th, — Arms quite %vell, legs nearly so. t7th. — All pain gone. T. 98 "2°, P. 7a. Mar. Z9th. ^75 T?l of acid in 10 oz. of water, to be taken as a drink in 14 h. No pain for 5 d, Pulse rose la per m, on and after 3rd d. Temp., previously elevated by lung complications, showed no change on 4th and 5th d., remaining at 99"^, instead of varying as usual for some time previously. After midnight of 5th d, pains in joints came on. ^On m. of 6th d, metacarpo-phalangeal and fir^it phalangeal joints of ist and 2nd "ngcrs of both hands were red, swollen, hot and painful. Pain much aggravated by 'movement. T. 994**^ P. lot. Heart-sounds clear. Discontinue acid, E. Pain and rtdness les*. Joints still stitf. No other joints affected. T, 99'!^. April 5th. — Hand much better. Took 30 V\ of acid in forenoon. E., swelling, redness, and tenderness retiirned in knuckles. Discontinue acid, 6th, — No pain. Took 45 n\ up to 4 p.m. At 9 p.m. swelling in knuckles and left wrist. No more acid for 2 d. Joint symptoms gradually disappeared. Resumed on 9th to 13th 3 5ll\ acid per diem. No symptoms till night of 13th, except frying pains about joints, then disturbed by severe pain in r. wrist, which in m. wa-s red, hot, swollen and painful. P. 98, full and soft. Copious perspiration, acid reaction. Elbows and knees stiff next day. In 4 d. little stiffness in r. wTist only remained. The acid taken again in a week with like results. Continued for some weeks taking io v\ per diem, and stopping a day or two. No pain. Early in June took 40 to 50 IT^ per diem. Two sharp attacks as before in the month. At end of month took 75 Tl^ daily, increased to lOQ on July 6th. On July 7th had pain and stiffness of joints, aggravated by walking, 8th, These sj^mptoms worse in e,, wrists and elbows vcr)' stiff" and painful. Knees less so. T. ioo*6°. Stop acid. Well by loth. Took on this day 100 l![ of acid, witb result similar to last. In addition had pain in 1. side. Heart-sounds clear. All pain subsided by July 17th. (Balt». Foster, CYmiffl/ Mididm^ ^, 144.)

a. Anot]ier man, suffering from diabetes i never had rheumatism. Took 30 or 40 ili of lactic acid per diem. On 4th d. had shaip pain in r. knee, witb itiffness, aggravated by walking. Severe pain in other joints. No swelling or redness. Skin soft and moist. Discontinue acid. Pain c^one in a d. On subsequently resuming acid for a week, was laid up with severe pam in elbows, shoulders, ankles, and knees, all aggravated by movement. Swelling and redness only in r. knee. Free perspiration. P. 96, full and soft. Discontinue acid. Well in a week. (JhiJ,)*

III. Exferimtnti on animals. — i. Injection of 5vij of 1. acid into peritoneal cavity of a healthy cat produced during life irregular and irritable action of heart 5 the beat* could not be counted. After death liver, kidneys, and lungs were found congested. The blood in r. heart dark, ilimy, soft, and cheesy. The mitral

• Kuek also has observed the same phenomena in a diabetic who was being treated with the acid {Beiiri^e zur FaiA, u. Ifur. da Diahctts, ii, p. 166).

valvf gmtly thirkennl, red and crdematoun. Small fibrinout dqxMk idhering to surface *>t v'aUc. KxiitUiiun uf glutinouft fluid on puncture with needle. Eodocardium of 1. venrricie intirnscly vascular, appearing like bright red velvet. Fericaidiiifli dry and slightly injcriid.

z Injiithin ot }(j or ^ij into pcritonral cavity of tix dogi, repeated after a few d. in in^^tanccs whrrr litt was prolun^ed. During life indications of pain in aD joints in 3 inNtanrt'««. In (ine inMancr pain and tcndcmeu over region of Mart. In all l)L-ats (it hrart wrrr sharp and quirk, wcond luund prolonged, lirrt obKOIv Where lite wa^ pnilonged a soft murmur was noticed on 4th d.^ and a loud ijttolic bruit on 5th. In one instance there was flight intermi»ion of puli«. After death, where it had occurred the first day or two, was noticed panive congertion of hmgs with hypenemin ot the upper lobe; pericardium dry, veancU finely injected ; cndocariiium, r. ^idv normal, one segment of tricuspid swollen leveral timet beyond natural si/e, the thickening bright red, irregular \ 1. side brilliant red and velvety in appearance, segments ot mitral vaU'e thick, crtlematuus, bright red, with beads around their tree margins. Aortic valves deep red. Muscular structure onusoaUy red. It lite ha<l been prolonged to 3rd or 4th d., on pericardium over 1. vcntriw there was exudation of plastic lymph ; the mitral valve was thickened and pale frooi exudation of lymph. In one instance the anterior curtain was adherent to the bcartp wail. The aortic valve slightly thickened. In one instance there was exudation into the pleural cavity. (B. W. Richardson, Camte rf Qnigdtamm ff BkU^ Appendix.)*

Volume I — Appendix

Acidum lacticum*— In I. 3, i, 6, after "produced*' add " — also profuse

secretion of tenacious mucus, which must be constantly hawked up."