Magnesium Sulphate.

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Synonyms—Epsom Salt, Sulphate of Magnesium.

Administration—For general administration it is better to give this agent in a hot solution. Usually one-half of the otherwise necessary dose will accomplish the same result if hot. It is stated that if an ounce be boiled for a short time in a pint of water to which a grain or two of tannic acid is added, it will be entirely deprived of its bitterness. In solution in hot milk, it is of value in debilitated patients. The dose as a hydragogue is from half an ounce to an ounce, well diluted. As an aperient and antacid, from ten to thirty grains will prove satisfactory.

Physiological Action—By osmotic processes, this agent abstracts water directly from the intestinal capillaries. This explains the efficient influence of the remedy in dropsy. Its solutions are not readily absorbed, and it directly stimulates intestinal peristaltic action. Concentrated solutions of the agent are more active in abstracting water, and thus more efficient when given for the reduction of dropsical effusions. The solutions so concentrated must be avoided if there be no dropsy. While epsom salt is considered perfectly safe, it has produced death in overdoses. Concentrated solutions when dropsy is not present occasionally produce from rapid absorption of the drug, marked constitutional effects, and death may occur, from convulsions or from suppression of urine. There has been extreme vomiting and paralysis. The agent is also poisonous when solutions are injected directly into the blood stream. There is a pronounced influence upon the respiratory apparatus with sudden respiratory failure.

Therapy—This agent is demanded when a non-irritating cathartic is needed, which will produce copious watery stools without nausea or pain. It is of much service in abdominal surgery, thoroughly evacuating the intestinal canal prior to an operation. Given in small doses it stimulates normal secretion, causes liquid feces and prevents any possible impaction. This is accomplished without stimulating the peristalsis to any great extent, or otherwise disturbing the muscular structure of the bowels.

It is a most available remedy in dropsy. If the skin is cool, it eliminates large quantities of water through the kidneys as well as from the intestinal canal.

If the character of the kidney disease is such that active elimination is undesirable, it will cause active transpiration through the skin instead, if the skin be thoroughly warm and moist at the time of its administration.

If the patient is greatly debilitated, it will not produce increased weakness, if it is given in conjunction with the carbonate of iron or some other mild, well selected tonic. If given when the stomach is empty, it seems to act more directly upon the kidneys, as a diuretic.

In the treatment of dysentery, given in small doses, it is an efficient remedy. It apparently has a soothing instead of an irritating effect, as have most cathartics in this disease.

It is valuable in impaction of the bowels from any cause. In this case fifteen grains of the salt with an equal amount of the bitartrate of potassium every two hours will produce satisfactory results. This combination is also useful as an antacid and refrigerant in many of the disordered conditions of the stomach and bowels during hot weather.

If the agent be administered in full doses in colica pictonum it will serve an excellent purpose. Inasmuch as sulphuric acid is a direct antidote in lead poisoning, the dilute acid may be added in small quantities to a solution of this remedy.

Dr. Vogler claims that it will produce sleep where the cause depends upon indigestion or constipation if given in dram doses. It is used both internally and externally in rheumatism.

I have had many reports during the last two years of the application of a solution of an ounce of epsom salt in a pint of boiling water to which ten or fifteen drops of carbolic acid has been added. This is not only beneficial wherever a fomentation is required but is a superior application, Dr. Gordon says, in the treatment of erysipelas.

There is a peculiar disease of the skin in old people characterized by a hard incrusted condition, dusky red or purplish, which cracks and bleeds, and fissures with a slimy exudate at times, which Dr. Waterhouse cures satisfactorily with the above solution.

Where the patient has a large number of warts which persist in spite of treatment, from two to five grains of epsom salts four or five times a day with a drop or two of thuja will cure, Dr. Webster says, in a short time.

As a pain reliever, this agent has come into prominence during the past few years, through the teachings of many observers: Burgess of Chattanooga claims it to be distinctly anesthetic. Externally applied in concentrated hot solutions, it often exhibits this influence satisfactorily for local inflammations. It was suggested for intra-spinal injections to control tetanus, and at one time to induce temporary anesthesia of the extremities and of the pelvic organs, but serious results followed its use in so many cases that it has now been largely abandoned.

Dr. Cooper advises the agent in ounce doses of the saturated solution every two hours in the treatment of amebic dysentery. After the first active operations, he gives thirty drops of this solution until the patient has entirely recovered, using starch, water and laudanum, if necessary for the tenesmus, and aconite in fever.

When salt rheum so called is present on the hands and fingers, he immerses the parts in warm solution for ten or fifteen minutes, at bedtime. Then draws on clean white cotton gloves for the night, repeating this each night until cured.

Where the urine scalds or burns in passing from high acidity, he cures with teaspoonful doses of this solution four times a day. Extreme gastric acidity is relieved by small doses frequently repeated.

He treats simple conjunctivitis by dropping a few drops of the saturated solution into the eye, to which is added two grains of cocaine to the ounce, He treats ascaris scabei with hot concentrated solutions applied at bedtime.

Dr. Burgess advised the use of this agent to reduce excessive fat. He treated a patient weighing 238 pounds, reducing him to his normal weight, 178 pounds at the rate of about ten pounds per month. His method was to bathe the body night and morning with a solution of one ounce of the salt to a pint of water. At the same time a teaspoonful of the same strength solution was taken internally three times a day.

The above course is recommended to reduce the quantity of uric acid in the system when excessive.

To unsightly and disfiguring scars, he applied the same solution preferably hot, twice daily. By so doing, he reduced them to a great degree, sometimes removing them entirely. Dr. Broadnax suggested that this treatment might prevent cancers, which develop in scars.

The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.