Aceticum Acidum

[acetic acid.]

Acetic acid is a colorless liquid of an intensely acid taste and of characteristic odor. Its specific gravity is 1.047. Applied to the skin, it acts as a stimulant and astringent; it also possesses eschar- otic properties.

A case of poisoning by this acid is reported in Franks Magazine. A man of thirty-six years, with a phthisicky habit of body, and who was recovering from an attack of pleuro-pneumonia, swallowed by mistake a dessert-spoonful of acetic acid. He jumped out of bed as if in a fit of frenzy, and rolled on the floor in the most excruciating agony. After swallowing a quantity of water, the patient complained of a violent, burning pain in the thorax and region of the stomach, as if the bowels were on fire; frightful anguish, oppression on the chest and disposition to vomit; he was scarcely able to speak; the whole body was covered with perspiration; pulse very much acceler- ated, small, contracted; the epithelium of the buccal mucous mem- brane looked whitish.

The effects of the acid were antidoted with milk and magnesia, and an oleaginous mixture. Copious vomiting and diarrhoea took place, after which the patient felt relieved with- out suffering from any other untoward symptoms.

GrASTRODYOTA. — This case of poisoning may suggest the use of acetic acid in gastrodynia, with burning pain in the stomach, and where the paroxysm terminates in coldness of the skin, and breaking out of a cold sweat on the forehead or over the whole bod}^. Five

44 ACIDUM ACETICUM.

drops of the acid in a spoonful of water may be taken during the paroxysm, to be repeated in an hour if necessary.

The following case of poisoning by acetic acid likewise indicates its use in peculiar and violent forms of gastrodynia. We find this case related by Professor Mitchell in his Materia Medica, who extracted it from the British American Medical Journal. The sub- ject was a widow with four children, who took, as nearly as could be ascertained, over a pint of common vinegar. The reporter states that she had been low-spirited for two or three days, in consequence of a sore disappointment, and then adds as follows:

" When I saw her, about three hours after she had taken the vine- gar, she was in bed, covered with a cold perspiration, and trembling from head to foot, and apparently alarmed at every body and every thing about her. Her breathing was very laborious and hurried; her countenance perfectly wild, and the pupils dilated; the tongue was dry and cold ; pulse ninety-six and full ; the abdomen much distended, with extremely acute pains at the scrobiculus cordis, so much so that the slightest pressure there caused her to shriek out.

She did not know anyone about her, not even her own children, nor had she any recollection of anything that had happened from the time of taking the vinegar, which was about eleven at night, not even of her having gone to bed, which she was the last in the house to do. About one o'clock, the inmates were all awakened by her shrieking for cold water, of which she had drank an enormous quan- tity before I was called to see her. There was not any pain, heat or constriction of the throat or fauces, but there were slight efforts to vomit.

Having procured some sulphate of zinc, I gave her two scruples in a cup of water, which soon produced full vomiting, with great straining. I had then to leave her, but ordered full and repeated doses of carbonate of magnesia, till I could see her again, which I did about six hours after, and found her much relieved, and only complaining of headache, which left her after the operation of a dose of castor-oil. Two days after, she was taken ill with a slight attack of continued fever,, but is doing well."

DYSPEPSIA. — In some forms of dyspepsia, where emaciation, aphthous degeneration of the buccal lining membrane, redness, sore- ness and burning of the tongue, acidity of the stomach, dryness of the skin, are leading symptoms, acetic acid, taken in two- or three- drop doses in water, morning and evening, may prove of great value.

Dr. L. D. Morse, relates the following case of dyspepsia, successfully treated with acetic acid. (Am. your, of Horn. Mat. Med., Sept., 1873.)

Some months ago I succeeded in relieving a most distressing case of dyspepsia by means of acetic acid, first and second decimal solutions, given every hour or two, according to circumstances. The symptoms were substantially as follows : Appetite good, but a short time after eating the contents of the stomach seemed to ferment,

ACIDUM ACETICUM. 45

and acidity, nausea and vomiting generally followed, attended with much relief; severe paroxysmal headache, with a species of ophthalmia was prominent. All the symp- toms were aggravated by any nervous excitement. The patient, for years, had been in the habit of using large quantities of soda to neutralize the acidity of the stomach ; but, of course, with only a partial and merely temporary relief. After using the acid for two months, taking it in water, less and less frequently, the gentleman announced himself cured.

The power of vinegar to cause emaciation, when taken in large quantities and for a length of time, has been improved by many individuals for the purpose of getting rid of their superfluous fat. Obesity being considered a serious disfigurement of beauty, young girls who are afflicted with what seems to them an excessive rotun- dity of person, have swallowed quantities of vinegar for the purpose of removing this defect. This abuse is said to have occasioned serious results in many cases. In the second volume of the London Medical Gazette, 1838-39, the following case is reported, which seems to show that this excessive use of vinegar may develop tuber- cular consumption, most probably, however, only in such individuals as are affected with a constitutional predisposition to this disease.

A few years since, a young lady, in easy circumstances, enjoying good health, was very plump, had a good appetite, and a complexion blooming with roses and lilies. She began to look upon her plumpness with suspicion, her mother being very fat, and she afraid of becoming like her. Accordingly she consulted a woman who advised her to drink a small glass of vinegar daily ; the counsel was followed, and the plump- ness soon diminished. She was delighted with the success of the remedy and con- tinued it for more than a month.

She began to have a cough, but it was at first dry,, and regarded as a cold that would subside. But from being dry, it was presently moist. A slow fever came on, with difficulty of breathing; her body became lean and wasted away; night-sweats, with swelling of the feet succeeded; and a diarrhoea terminated her life. On examination, all the lobes of the lungs were found filled with tubercles, and somewhat resembled a bunch of grapes.

This case leads us to infer that moderate doses of vinegar may prove an excellent palliative in cases of tubercular consumption with fatiguing, titillating cough, profuse expectoration of purulent mucus, oppression of breathing, hectic fever, night-sweats, extreme emaciation.

ACIDITY OF THE STOMACH.— This acid has been found a valuable corrective, even by leading old school practitioners. In obstinate cases, where the alkalies had been tried without the least benefit, acetic acid has either effected a cure, or has proved the best palliative.

Acetic acid has been extensively used as a palliative by old-school practitioners in a variety of diseases, more especially in licemoptysis, in the diarrlma supervening in the latter stages of typhus, or in hectic fever ; it has likewise been used more or less effectually to check the night-sweats with which phthisicky patients are often troubled.

40 ACIDUM ACETICUM.

SPERMATORRHOEA.— The astringent virtues of this acid have been successfully employed in the treatment of spermatorrhoea, sev- eral cases of which are reported in Frank's Magazine. Compresses saturated with a decoction of the root of pomegranate in concen- trated vinegar were applied to the perineum. In some cases the vinegar was used without the addition of any astringent whatsoever. A care is said to have been effected in from ten to thirteen days.

Even in syphilitic ulceration (chancre, etc.,) the acid may be of great use. In a discussion on ulcers and their treatment (Horn. Med. Society of Cincinnati), Dr. Wm. Owens stated, that he uses acetic acid in the first decimal dilution as a wash for all kinds of chancres with invariably good results.

It should be remarked, however, that this treatment is only appli- cable to recent cases. In inveterate cases it may prove insufficient, or may, at any rate, have to be accompanied by the use of internal medicines. If the perineal region should become sore, the acid has to be discontinued for a time.

This palliative use of acetic acid is not by any means contrary to the law of cure. Palliative means within proper limits, and fulfill- ing the legitimate purpose of palliation, viz., palliation from suffer- ing without subsequent aggravation of the pain, are admissible under any form of treatment. In many cases, palliation may not only be equivalent to, but may constitute a cure.

Another palliative, or if you prefer, physiologico-therapeutic effect of concentrated vinegar is witnessed in the successful treat- ment of

ASCITES AND ANASARCA. Several cases are reported in Huf eland? s Journal The dropsical effusion set in in consequence of suppression of fever and ague and acute eruption. The patients took the vinegar in teaspoonful doses every hour or every two hours; copious diuresis and diaphoresis set in after the acid had been taken for a couple of days, and a complete cure was the result in a number of cases. The appetite, so far from being impaired by this treat- ment, had, on the contrary, to be checked.

We have already alluded to the palliative uses of acetic acid in typhus. Dr. Parrot, of Dorpat, Russia, instituted a number of exper- iments with vinegar in the treatment of the epidemic typhus of 1812. He gave to adults four table-spoonfuls a day, mixed with two parts of water. It was given indiscriminately in cases with or with- out diarrhoea.

ACIDUM ACETICUM. 47

Iii one case an exhausting diarrhoea set in on the seventeenth day, which was very speedily modified by the internal use of vinegar.

In another case, typhus with violent delirium, pains in the abdo- men, rumbling and diarrhoea, soon yielded to vinegar, except the pain, which continued for some time.

A boy of two years had typhus with stupor, delirium, distention of the abdomen, obstinate constipation. Vinegar soon produced large, soft, but by no means diarrhoeic stools, and the child was convalescent in twenty-four hours.

A man who had been suffering for years with pains in the liver, was attacked with the following symptoms : violent local pains, difficult respiration, frightful paroxysms of anguish ; sleeplessness ; vomiting after every meal ; weakness of sight, extreme irritability of temper. After using vinegar for two days, he had twenty-seven soft, not diarrhoeic stools ; on the eleventh day he was again able to attend to his business, but the sight remained weak.

In the month of September, 1854, Dr. Cceur, of Caen, France, published the fol- lowing treatment of the itch in the French medical journals :

" One of the inconveniences of hunting and walking in the fields is, very frequently, the insertion beneath the epidermis of a little bug of the genus acarus which causes little vesicles upon the skin sometimes surrounded by inflamed areolae and causing the most furious itching. The most effectual means of arresting and, indeed, completely removing the trouble, is to rub the skin with concentrated vinegar. Applying this remedy to the itch-mite, I have so far succeeded in radically curing ten cases.

By means of a somewhat rough sponge which is saturated with good vinegar, I cause friction to be made, three times a day, upon the skin by which means the vesicles are torn. At an average, a cure was effected in less than five days. This mode of treatment has this advantage over the ordinary method, that it is cheap and free from all unpleasant odors ; that it operates speedily, can be kept secret and is easily applicable."

It is well to be acquainted with such simple experiments which you may have many opportunities of repeating.

The claim has been made, that acetic acid, in the form of vinegar, possesses prophylactic virtues in epidemics of small-pox. The Austrian government commissioned Dr. Roth to visit Upper Silesia, where a very malignant epidemic of small-pox had broken out among the peasantry, who herd together in poorly-ventilated huts and are un- clean in habits, wearing woolen clothing from season to season. Acting on the theory of a veast-ferment as characteristic of the poison, Dr.

Roth ordered two table-spoonfuls of common vinegar after breakfast and toward evening for fourteen days; to half-grown and feeble persons he gave one-half this dose. The result of this prophylactic treatment was favorable beyond his hope. Not one fatal case occurred even when the disease was quite developed, and eight out of ten of those exposed escaped the disease altogether, and the small number of the sick was but little affected; pustules were few and sequelae none. (Med. and Surg.

Reporter, March, 1873).

In cases of poisoning with acetic acid we resort to the use of an alkali or some substance containing an alkali — for instance, soap.

48 ACIDUM BENZOICUM.

ACIDUM BEI^ZOIOUM.

[benzoic acid.]

It derives its name from the gum benzoin or benjamin, which is the concrete juice of a tree, the Styrax benzoin, a native of Sumatra, Java, Siam. The acid occurs in white, feathery crystals of a silky lustre. Its taste is characteristic, somewhat acrid. Its odor resem- bles the vanilla and is due to the presence of a volatile oil. It is soluble in two hundred parts of cold water; also in twenty-five parts of warm water. It is contained in nearly all balsams.

In 1840, Dr. Ure recommended benzoic acid as a remedy likely to prevent the formation of tophous secretions in gouty subjects. He prescribed it in doses of one scruple, to be taken an hour after a meal. By adding to the urine voided, one-twelfth part of muriatic acid, beautiful rose-pink acicular crystals were obtained, to which Liebig has assigned the name of hippuric acid. In the urine the hippuric acid was thus found to have taken the place of the uric acid, none of which was discoverable in the urine.

As the salts formed by the combination of the hippuric acid with the alkaline bases are much more soluble than the corresponding compounds of uric acid, Ur. Ure supposes that the substitution of the former for the latter may be the means of preventing tophaceous secretions, etc. He remarks that "the application of the above principle has proved of material benefit in the treatment of certain unhealthy conditions of the urine, occurring in subjects of a calcu- lous or gouty diathesis, since it enables the practitioner to obviate entirely the various depositions resulting from the excess of uric acid, the fruitful source of that most distressing malady, stone in the bladder; as also to control and prevent the formation of the so-called tophaceous concretions or chalk stones, which occasion so much in- convenience, deformity and pain to individuals laboring under gout."

On the other hand W. Keller states that, "so early as 1831, Pro- fessor Woehler had expressed the opinion that benzoic acid, during digestion, was probably converted into hippuric acid. W. Keller took thirty- two grains of pure benzoic acid, in syrup.

Perspired profusely; he next took the same dose three times. The urine voided the next morning, when treated with muriatic acid, yielded considerable hippuric acid, but it also contained its normal propor- tions of urea and uric acid. Keller remarks that " this observation is opposed to the statement of Dr. Ure, and that he is certainly too

ACIDUM BENZOICUM. 40

nasty in recommending benzoic acid as a remedy for the gouty and calculous concretions of uric acid."

The late Dr. Jeanes, of Philadelphia, who furnished an interesting monograph on this agent in the first volume of the Transactions of the American Institute, recommends benzoic acid for

CONCRETIONS IN THE JOINTS, when resulting from rheumatism or gout, with red urine having a strong odor. It is like- wise recommended for syphilitic rheumatism of the joints, where this peculiar character of the urine is present. I am somewhat inclined to regard this recommendation as theoretical; however, it may be substantiated by subsequent experience.

BLADDER, AFFECTIONS OF THE Benzoic acid has been successfully used in various affections of the bladder, including irritated and inflamed states of the organ of various degrees of intensity. From a report of a series of papers prepared by a com- mittee of members of the Horn. Med.

Society of Pennsylvania, I take the following symptoms, covering nearly all the conditions of the bladder which may call for its exhibition : " Vesical catarrh. Irri- tability of the bladder. Nocturnal enuresis in children. Too frequent desire to evacuate the bladder, the urine being normal in appearance.

Decrease of the quantity of urine. Urine aromatic. Urine of a very repulsive odor [when freshly voided Ed.], of a changeable color, brownish, cloudy, of an alkaline reaction.

Dark, reddish-brown urine, of greater specific gravity than normal urine, with an acid reaction. Excess of uric acid. The patient is pale, languid, with a feeling of weakness in the loins. Fleeting pains in the region of the bladder.

A granular mucus, mixed with phos- phates, in the sediment of the urine." (Halm. Monthly, Oct., 1876.)

NOCTURNAL ENURESIS— Benzoic acid is of especial value in the treatment of nocturnal enuresis, when the urine is very highly colored, of an aromatic or, at times, very repulsive odor; there will probably be an excess of uric acid and a high specific gravity of the urine; irritability of the bladder; languor of the patient.

A young lady, seventeen years old, had been afflicted with enuresis for ten years, and had been under constant, but unsuccessful treatment. She was cured with the second decimal trituration of benzoic acid. A few doses of cantharides3 were given, as an adjuvant, after the use of the acid. She had no enuresis after taking the first dose of the acid, until nearly a year later, when the difficulty returned and was promptly and, we understand, permanently cured by the same remedy.

(Am. Horn. Observer, Vol. I, page 182.)

Dr. Jeanes, in the paper previously referred to, gave the following symptoms as a key-note of the drug: urine scanty, of dark brown

VOL. I. — 3.

50 ACIDUM BENZOICUM.

color, and the urinous odor highly intensified. Dr. H. N. Guernsey claims to have repeatedly verified this indication, and adds that in

RHEUMATISM these symptoms are often present and that, when such is the case, the drug cures promptly.

Dr. Hering (Am. Jour, of Horn. Mat. Med., July, 1869,) gives the following symptoms: During the night gout commences in the joint of the great toe of the right foot; next day somewhat lessened; twenty-eight hours after this pain began he was able to walk out, and also observed the cessation of a white sediment in his urine.

BRIGHT'S DISEASE OF THE KIDNEY— Circumstances may arise under which you may find the remedy of value in Bright's disease of the kidney, but only when there exists the strongly marked odor of the urine, peculiar to the drug; and especially so, when the patient is of a well-marked gouty diathesis; there may also be present vesical catarrh.

NEPHRITIC COLIC— Mr. A. C. Clifton, of Northampton, (Monthly Horn.

Revieiv, July, 1868,) states that he has used the acid with benefit in nephritic colic, when there was at the same time frequent micturition, with the urine of a deep-yellow color, strong smell, and acrid character, causing excoriation of the external parts with which it came in contact. He also mentions having used it successfully for nocturnal enuresis, when there was much irritability of the bladder during the day and the quality of the urine was char- acteristic of the drug.

In fact the advantageous use of the remedy depends very largely upon the presence of the two conditions so repeatedly mentioned, namely, the peculiarity of the urine and the rheumatic diathesis of the patient, both going hand in hand. This is the indication for its use in many difficulties of organs, which are not primarily affected by the drug. There is, for instance, the heart. The acid certainly exerts no direct effect upon that organ, and yet we have no more useful remedy in heart affections, when we find co-existing difficulties of the kidneys, whether functional or organic, and characterized by symptoms which call for this remedv.

A young woman, seventeen years old, suffered from severe palpitation of the heart, aggravated at night and when lying down, so that she was obliged to remain out of her bed half the night. The examination of the heart showed no morbid alterations. Menstruation was regular ; from time to time she suffered from tearing rheumatic pains, either in the upper or lower extremities ; pulsatilla alleviated the morbid state, but did not remove it. The patient who was a close observer, and well versed in homoeopathy, directed our attention to the circumstance, that the palpitations ceased, when she had the tearing pains in the lower extremities.

I gave her acidum benzoi- cum, and after the second dose the palpitation passed off, and did not return for a long while, and then only in short and feeble attacks. Rheumatic pains she had

ACIDUM CARBOLICUM. 51

only when catching a severe cold, and then lightly. Acidum benzoicum deserves more attention in cases where gout or rheumatism is complicated with affections of the heart, especially when metastasis threatens in gout or in affections of the joints. {Am. Jour. Horn. Mat. Med., Vol. Ill, page 34.)

ASTHMA. — In the Hahnemannian Monthly, Sept., 1867, its use in asthma is mentioned and the following interesting case given:

The patient was a gentleman, forty-five years old, who had suffered from frequent returns of asthma for more than twenty years ; venesection on his first attack had doomed him to long-continued suffering, and he had tried all possible rational and irrational remedies. Saltpeter no longer relieved him. I found him ill; his lower extremities much swollen (oedema), and his strength much diminished. The urinary secretion was almost suppressed, and the very small quantity of urine passed by him but twice in twenty-four hours, was of a dark color and of a very disagreeable, pungent smell.

Guided by this well-known symptom of acidum benzoicum, I gave him one dose of the remedy. Very shortly afterward he had the worst paroxysm of asthma he ever experienced ; the attacks then became less frequent and less severe. After three days the urine became quite profuse, with considerable sediment, but without the former pungent smell, and much paler. After ten days more, the urine again becoming dark and slight attacks of asthma returning during the early morning hours, I administered another dose of benzoicum acidum11000 (Fincke).

He improved, progressed well, and was, some weeks later, restored to full health.

In the case of a gentleman seventy-two years of age, (who had suffered long from gout and asthma, which latter generally appeared on the 4th of July, and always left him with a violent attack of gout), the same urinary symptoms led me to give him benzoicum acidum. The asthma had always been worse after lying down, and especially after midnight, when he was compelled to sit until morning in a chair inclined forward ; there was no anxiety or restlessness present, the absence of which symptoms counter-indicated arsenicum, which might otherwise have been selected as the homoeopathic curative agent. Two doses of benzoicum acidum11000 cured the case, and no gouty symptoms followed, as in the previous attacks.