Gallicum Acidum

[gallic acid.]

Gallic and tannic acids constitute the active soluble ingredients of nut-galls, which are caused by a small insect that deposits its egg in the tender shoots of the tree. Gallic acid may be obtained by expos- ing a watery infusion of nut-galls to the air for some six weeks. The sediment which is an impure gallic acid, is purified by boiling it in distilled water ; it is afterward decolorized by animal charcoal and crystallized.

Gallic acid occurs as a white powder of strongly marked astringent taste ; it is soluble in one hundred parts of cold water, in three parts of boiling water ; it also dissolves readily in alcohol and ether.

Gallic acid is considered by many old school practitioners as the best internal styptic, superior even to tannin. Ohristison designates gallic acid as an internal astringent which may be advantageously used for the relief of mucus discharges from the bowels or urinary bladder. He has seen menorrhagia very promptly subside under its use. Dr.

Todd writes in the London Medical Gazette, Jan. 19, 1849, that "in all cases of haemorrhage, whether haemoptysis, haemateme- sis, haematuria, or any other form dependent on haemorrhagic tendency, he considers it to be the best styptic we possess."

ACIDUM GALLICUM. 09

The styptic character of the acid has caused it to be tried in albu- minuria, in ten-grain doses, every three, four or six hours.

The excessive expectorations of phthisis and bronchitis are much lessened by gallic acid. Dr. Marcy informs us in the first number of the N. A.

Journal of Homoeopathy, that " in the case of a young lady who had a cavity in the left lung, with copious expectoration of pus, night-sweats, frequent haemorrhages from the lungs and bowels, evening fever, and pulse one hundred and thirty to the minute, the prolonged use of gallic acid, first trituration, dried up the cavity, stopped the expectoration, the sweats, the haemorrhages and the fever, and enabled the patient to regain her flesh and strength. Eight months have now elapsed since the cessation of these serious symptoms, and the lady experiences no difficulty except great short- ness of breath upon the slightest exertion.

Her flesh, strength and general appearance are the same as when she enjoyed perfect health; but the sound of the left lung on percussion is dull."

In the American Observer, Nov. 1872, we find a proving made with gallic acid by Dr. D. T. Kimball :

One grain of the acid, triturated with sugar of milk (twenty grains) produced an increased secretion of pale urine and distention of the bladder ; diminution of appetite. Amorous dreams. Faint- ness and sickness in the bowels. Soreness and pain in the rigjit lung, increased by coughing and inspirations.

A later proving developed : Photophobia and burning, itching of the eyelids, dryness in the throat and mouth, and bad taste. Aching in the lungs, with soreness in the muscles of the neck, especially on moving and turning the head. Itching of the skin.

The prover took the acid when he labored under a gastric derange- ment, with a group of symptoms somewhat similar to those experi- enced during the proving ; he received prompt and beneficial results from the remedy.

PYROSIS. — It may be supposed that in certain forms of pyrosis, with rising of an acrid-sour fluid, gallic acid will act favorably. Dr. Bayles remarks that it not only checks the secretion with more certainty and rapidity than he has ever seen follow the administra- tion of any other remedy, but it gives general tone to the stomach, increases the appetite, and even removes constipation in many cases.

70 ACIDUM HYDROCYANICUM.

ACIDUM HYDEOOTAJNICUM.

[hydrocyanic acid, prussic acid.]

A compound of hydrogen and cyanogen. This acid, although a most formidable poison, may nevertheless prove a most useful thera- peutic agent in the hands of cautious and enlightened practitioners. It should be kept in dark, closely-stoppered vials. It is only fit for use as long as the preparation is perfectly colorless, and has the pungent odor which is peculiar to this agent. Attenuations are made with strong alcohol. They have to be renewed frequently, as this acid is very apt to spoil by decomposition.

In the shops, hydrocyanic acid is made with variable degrees of strength. Anhydrous hydrocyanic acid is never used in medicine. This article undergoes speedy decomposition. Dr. Ohristison has kept it unchanged for a fortnight in icy-cold water.

Diluted or medicinal hydrocyanic acid has the taste and smell of the strong acid, but in a lesser degree. Acid prepared according to the London Pharmacopoeia, contains two per cent of real hydrocy- anic acid; that which is prepared according to the Edinburg Phar- macopoeia, contains three per cent and a little more than one-fifth ; acid prepared according to the Dublin Pharmacopoeia, contains rather more than two per cent ; and the officinal acid prepared in the United States, has a little more strength than the London acid.

A medicinal dose, according to the old school standard, necessa- rily varies with the kind of acid employed. A dose of the London acid is from two to seven drops ; of the Edinburg acid, from one to four ; of the Dublin acid, from one to five, and of the United States acid, from one to six drops. In homoeopathic practice we never give such large doses. From the first to the sixth and even twelfth attenuation answers every therapeutic purpose to be obtained by an homoeopathic physician.

According to Wibmer, hydrocyanic acid decomposes the blood, destroys its coagulability, annihilates the process of oxygenation, and has a specific action upon the spinal marrow, more particularly upon that portion which presides over the functions of the lungs and heart ; it affects, however, every portion of the spinal cord and the brain likewise. It disturbs and paralyzes the functional power of these organs ; hence the impeded labored breathing, the retarded

ACIDUM HYDROCYANICUM. 71

circulation, the lassitude, stupefaction, the dilatation of the pupils, insensibility, paralysis, death.

In most cases, especially in cases where death does not set in sud- denly, as in the case of warm-blooded animals, this paralysis of the spinal marrow and brain, is either preceded or accompanied by a violent excitation of these organs, which accounts for the convul- sions, distortion and rigidity of the limbs, the trembling and tetanus.

Pereira thus sums up the post-mortem appearances in cases of poisoning by this acid: "Glistening and staring expression of the eyes, which, however, is not a constant phenomenon ; nor is it peculiar to this poison, for the same is observed after death by car- bonic acid, and in other cases (Christison) ; the odor of the acid is oftentimes very obvious in the blood, brain, chest or stomach ; the venous system is, usually, gorged with blood, while the arteries are empty ; the blood is, in many cases, florid, dark, or bluish-black, and viscid or oily ; the vessels of the brain and spinal marrow are fre- quently gorged with blood ; and the cerebral ventricles sometimes contain a serous or sanguineous liquor ; the lungs are, in some instances, natural, in others turgid with blood ; the internal lining of the stomach is sometimes red."

These post-mortem phenomena show that Wibmer's account of the action of prussic acid is in accordance with pathological facts.

Wedemeyer made the following experiment, which shows the inde- pendent action of the acid on the spinal marrow : He divided the spinal cord between the last dorsal and the first lumbar vertebrae, so that the hind legs were completely paralyzed and insensible to mechanical irritants ; hydrocyanic acid was then introduced into one of the hind legs ; in one minute symptoms of poisoning com- menced ; the hind as well as the fore-legs were violently convulsed, and in twelve minutes the animal was dead.

According to Professor Joerg, of Leipzig, hydrocyanic acid may destroy life in two ways ; first, by prostrating at one blow the func- tional power of the brain and nervous system, and extinguishing the sensibility ; and, secondly, by gradually arresting the process of oxygenation. In the former case, the animal dies suddenly, without the poison having had time to develop visible effects in the body ; in the latter case, the above mentioned pathological appearances will be met with more or less.

In consequence of the extreme violence with which this poison acts, we have very few cases of poisoning which can be rendered

72 ACIDUM HYDROCYAKICUM.

available for therapeutic purposes. If the poison is taken intention- ally, as a means of self-destruction, death generally overtakes the victim before help can be of any avail. The following case of poisoning reported by Dr. Letheby, in the Lancet, gives a fair view of the effects which a poisonous dose of prussic acid usually produces :

A girl aged twenty-two years, swallowed by mistake a dose of prussic acid, equivalent to a little less than one grain of the pure poison. At the time when this was taken she was sitting in a chair ; but she instantly jumped up, ran for a short distance, holding up her arms, and gasping, as it were, for breath ; she then fell, became insensible, and was violently convulsed, the muscles of her face undergoing great distortion, her limbs becoming spasmodically extended and her head drawn down upon her shoulders.

In this state she was removed to her bed and was seen directly afterward by Mr. Watson who found her lying on her back, with the body drawn a little forward ; the limbs fixed and extended in tetanic spasm ; the whole face swollen, turgid, and almost purple from congestion ; the jaws clenched, the mouth covered with foam, the eyes half closed, but prominent and glistening, with their pupils widely dilated, and quite insensible to the stimulus of light. She was breathing slowly, with deep, prolonged inspirations, and uttering a low, moaning noise ; the pulse at her wrist could not be felt, although the heart still continued to beat with a feeble, fluttering effort.

At this time, which was ten minutes before her death, the medical gentlemen had discovered that she was suffering from the action of hydrocyanic acid, and they instantly adopted means for her recovery, but without the least avail, for the breathing became slower and slower, the limbs at this time remaining fixed and immovable, and she died in from fifteen to twenty minutes after swallowing the poison.

The post-mortem appearances in this case were as usual in cases of poisoning by hydrocyanic acid ; the cerebral vessels, both upon the surface and in the substance of the brain, full of black, fluid blood ; the lungs highly congested, but free from tubercle or other disease ; the cavities of the heart full of black, uncoagulated blood.

Beside the interesting provings of hydrocyanic acid by Professor Jcerg, we have some heroic provings by other experimenters.

Coullon says that the accidental inhalation of the vapors of prussic acid caused a person to fall down, with anxiety, fainting, vomiting, loss of mobility.

Ittner, while preparing the acid and inhaling the vapors, experienced constriction of the chest, difficulty of breathing, vertigo, weariness, shivering.

Coullon says in his Eecherches sur Pacide Hydrocyanique, that he gradually swallowed twenty, thirty, forty, fifty, sixty, eighty, and

ACIDUM HYDROCYANICM. 73

eighty-six drops of prussic acid in the same quantity of water ; the taste was intolerably bitter. The first doses had no effect. The last mentioned doses caused the following symptoms : Increased secre- tion of saliva for a few minutes, and two or three attacks of nausea ; the pulse rose from fifty-seven to seventy-seven or seventy-eight beats ; in an hour and a half it resumed its normal frequency. For some minutes the experimenter complained of heaviness of the head and some headache which seemed to be localized beneath the hairy scalp on the anterior portion of the head.

For upwards of six hours, Coullon experienced a marked anxiety in the region of the heart, alternating with a slight throbbing pain in the same region, which did not increase by pressure.

In this proving we would point out to your attention the special action of the poison upon the heart and brain.

In the Revue Medicate, the following bold proving is reported, which was instituted by a physician of Rennes in France :

Having on two previous occasions swallowed a teaspoonful of the medicinal acid (which was probably very much diluted,) without experiencing any-ill effects from the poison, he swallowed another dose of the same size on the third of September, 1824, about seven o'clock in the evening. This acid had been prepared in one of the best pharmacies in Paris. He swallowed a teaspoonful of it in two doses at an interval of a few seconds. Immediately after swallowing the acid, he felt a sort of concussion in the head which caused him to apprehend mischief ; he then fell suddenly as if struck by lightning.

The first effects of the poison were, sudden loss of con- sciousness and sensation ; lock-jaw ; recumbent position increasing- dyspnoea ; coldness of the limbs ; wheezing, rattling breathing ; distortion of the mouth ; small pulse, which was scarcely perceptible at the left wrist ; wild-looking and bloated countenance ; bloating of the neck ; immobility and dilatation of the pupil ; the breath smelled of bitter almonds. At this stage, frictions were made with the spirits of cantharides, ammonia, and mustard-poultices were applied.

The lockjaw increased ; soon after, the trunk was spas- modically bent forward. After the lapse of an hour a violent spasm took place, during which the body became rigid, the arms were twisted, and the abdomen and the region of the stomach became distended. The jaws were opened by means of an iron spoon, and the fauces tickled with a feather. The patient vomited a blackish mucus.

Some coffee was administered, together with oil of turpentine. Ice was applied to the head. Two hours and a half after swallowing the poison, the patient manifested signs of sensibil- ity. He recognized his friends, his mind gradually resumed its activity; the breathing, however, remained oppressed, with a good

74 ACIDUM HYDROCYANICUM.

deal of rattling; from time to time he Lad an attack of cough, with discharge of pale-yellow mucus. An injection brought away five or six stools, and he belched up wind strongly smelling of prussic acid- He felt no symptom of paralysis, and left his bed Avith perfect ease. About six o'clock in the evening (next day), the difficult and rattling- breathing had subsided, the patient was carried home, and ascended two flights of stairs without any difficulty. On the fourth of September, the stomach was somewhat bloated, but painless, the head embarrassed, skin rather hot, pulse full.

The patient com- plained of pain at the tongue and in the back part of the mouth, where the parts were found inflamed and ulcerated.

On the fifth of September, twelve leeches were applied to the pit of the stomach, where the patient experienced some pain. In the evening, the head again felt embarrassed, with fever, sleeplessness,. pain in the throat. All the symptoms of a violent pulmonary catarrh showed themselves.

On the ninth of September, the difficulty of breathing continued, the cough troubled him very much and the fever continued. On the eleventh the fever decreased. On the thirteenth day after the poisoning, he went out for the first time. The general prostration and the difficulty of breathing continued for upwards of a fortnight, afterward he recovered his health perfectly.

From this exceedingly instructive case we learn that prussic acid affects the brain similarly to what we see in cerebral epilepsy ; that it causes an inflammatory catarrhal irritation of the larynx and bronchial ramifications ; that it causes long-lasting irritations, pains and swelling of the epigastrium, and general prostration with fever.

Sandras reports in the December number of the Gazette Medicate, 1829, that hydrocyanic acid, if taken in small doses, causes formica- tion, prickling, sleep or else sleeplessness, frequently headache, shivering. Larger doses cause vertigo, buzzing in the ears, a sort of delirium, intoxication. In the stomach it causes a feeling of warmth, which soon spreads through the bowels and extremities ; five minutes after, sweat breaks out in some cases.

Let us now examine the effects of hydrocyanic acid upon the organism under their respective groups.

CEREBROSPINAL GROUP.

We have learned from post-mortem examinations in cases of poisoning, that the cerebral vessels are gorged with blood. This must have been the condition of the cerebral vessels during the life- time of the patient. Joerg's instructive provings with this acid confirm the specific action of prussic acid upon the brain. These

ACIUUM I1YDR0CYANICUM. 75

provings were instituted with the acid prepared according to Vauquelin's, and also with the acid prepared according to Ittner and Brande's method, the latter acid being stronger than the former. The dose employed was from half a drop to three drops. The results of their provings show that prussic acid acts chiefly upon the cerebral centers, upon the respiratory organs, the heart, and likewise upon the bowels and bladder. Evidently the alvine and urinary functions are influenced secondarily through the ganglionic system.

Jcerg's pro vers have recorded the following cerebral symptoms developed by the acid : One of them experienced, dulness in the frontal region, cloudiness like intoxication, dimness of sight.

Another prover felt a pressure from the occiput to the forehead ; transient vertigo, followed by violent pressure in the occiput and forehead, especially in the right side ; from three drops this prover experienced stupefaction and vertigo, wavering of surrounding objects, dimness of sight, he was scarcely able to stand ; these symp- toms were followed by great dulness in the forehead and occiput.

Another prover has recorded the following symptoms : Pressure extending from the top of the head to each orbit, where it became fixed, and from the top of the head to the occiput, followed by drowsiness and lassitude. These symptoms were caused by one drop of the acid. Three drops caused a sudden paroxysm of vertigo ; the air seemed to move slowly around the prover ; there was no stagger- ing; the sensation was attended with slight pressure from the occiput to the left side of the forehead ; during this attack the eyes seemed immovable, the pupils were at first dilated, afterward permanently contracted ; the pulse varied, at times it was strong, at others, feeble ; the attack which the prover describes as a sort of intoxication, lasted ten or fifteen minutes ; it was followed by a scraping sensation in the throat, dyspnoea, difficult breathing, as if the lungs could not expand ; drowsiness, loss of strength.

Professor Jcerg himself took two drops ; they caused a scraping at the root of the tongue and in the throat ; slight shiverings, followed by dimness of sight, and a weary feeling in the brain ; for some days the prover complained of aching pains now in one, then in another part of the head, a want of clearness of perception, irritable temper, inability to perform mental labor.

Three drops of Ittner's acid caused obscuration of sight, intoxica- tion, with pressing pain in the head, changing to a stitching and boring pain in the frontal and orbital regions.