Occurrence—Phosphorus was discovered by Brandt in the product of evaporated urine, in 1669. It does not occur free, but is always found in combination, most often with calcium, sodium and potassium. It is derived from the ashes of bones, in which it exists as the tricalcium phosphate.
Description—An elemental, translucent, wax-like, yellow solid, luminous in the dark, unstable in the air; insoluble in water, but soluble in alcohol, petroleum, ether and the bisulphide of carbon. It melts at 112 degrees, boils at 554 degrees, giving off a colorless vapor.
It may exist in two distinct allotropic states. The first is the form just described, and the second is the variety known as the red phosphorus. The red variety is insoluble in those solvents which will dissolve the other form. It has no odor, does not oxidize in the air and is neither luminous nor poisonous. It is prepared by retaining the ordinary variety at a heat of 500 degrees for thirty-six hours. The heat destroys its affinity for oxygen.
Administration—It should be given in doses of from the one-one hundred and sixtieth to one-eightieth of a grain and repeated according to the indications. Larger doses may be given if its physiological effects are desired.
A tincture is prepared by macerating phosphorus for thirty days in alcohol, with occasional agitation, in the proportion of fifteen grains to the ounce. It is not officinal. One drop of specific medicine phosphorus, carefully increased, may be given as a dose.
Physiological Action—It is violently poisonous, producing its effects by deoxidation of the blood. In overdoses it produces violent inflammation of the stomach and intestines, intense burning pain, prostration, cold skin, clammy perspiration, vomiting and death. There is great anxiety, restlessness, intense headache, vertigo, wild erotic delirium and coma. The vomiting is of a coffee-ground liquid, resembling the black vomit of yellow fever. The urine is scanty and albuminous, and may be finally suppressed.
Its protracted use will in some cases induce a phosphorus habit, very difficult to overcome.
The agent is the most powerful nutritive stimulant to the nervous system, and a valuable nerve tonic-a trophic in the strictest sense, as it supplies a needed constituent. For this effect it is given most often in its combinations, but there are specific effects that can only be obtained when the agent is given in its uncombined form. After a dose of the one-twentieth of a grain there is a peculiar exhilaration experienced, a renewed capacity for mental and physical exertion. There is increased strength and renewed vigor.
The acids of Phosphorus, and the phosphates and hypophosphites, are common restoratives to the osseous and nervous structures of the system.
Specific Symptomatology—Its direct indications are exhaustion of the nerve forces, more or less complete, of a general character, as that following protracted fevers and malignant disease. Occipital headache of nervous exhaustion, especially that following mental strain and over-work. The insomnia of nervous prostration is quickly relieved by it.
Therapy—In loss of nerve force of a local character it is reliable, such as functional impotency, neuralgia from cerebral anemia and weak heart action from nervous exhaustion. It is valuable in mental failure, in paralysis agitans and in certain diseases of senility.
The remedy in minute doses acts directly upon the organs of the chest. It overcomes and prevents pulmonary engorgement. It quiets the cough of phthisis, strengthens the patient, moderates the diarrhea in these cases, and removes chest pains. It is a valuable agent in dyspnea, whatever the cause, whether of heart faults or disorders of the lungs. For stitches in the chest of a neuralgic or inflammatory character, it is specific. It is valuable in bronchitis, pneumonitis and pleuritis, with the indications of increasing weakness, sharp stitchlike pains, and short, dry, hacking cough. For intercostal neuralgia it is very sure.
Beyond these indications it has been used successfully in many cases of malignant jaundice. Its direct influence on the urinary apparatus is to induce diuresis with relief of existing irritation. It relieves vesical and prostatic irritability, especially if from sexual excesses. It has been used with good results in psoriasis, lupus, eczema and acne.
Toxicity—The eating of match-heads by children induces poisoning, also an overdose of the agent in medicinal form. The symptoms are a peculiar taste in the mouth and the odor of the substance on the breath. There is burning pain throughout the gastro-intestinal tract. There is vomiting and purging of matter which may be luminous in the dark. Symptoms of gastrointestinal inflammation rapidly follow, involving the intestinal and glandular organs. The condition of the liver, post-mortem, is similar to that of yellow atrophy, although at first it may be enlarged. There is fatty degeneration of all organs. Jaundice will finally occur, with vomiting of coffee-ground matter. There is obstinate constipation, with clay-colored feces. Muscular twitchings, vertigo, extreme headache, delirium, becoming wild; spasms, unconsciousness and death ultimately follow. The urine becomes dark-colored, scanty and albuminous, with fatty casts.
In parties subjected to constant contact with phosphorus a chronic form of poisoning occurs, as necrosis of bone, beginning with necrosis of the inferior maxilla. It is said none are safe from an attack if they work two years in phosphorus.
Antidotes—If phosphorus has been recently taken, the stomach must be evacuated at once. An old ozonized oil of turpentine is the physiological antidote, but it can seldom be obtained, and the fresh oil or other oils will facilitate the absorption of the agent. The permanganate of potassium is a correct antidote. Dilute solutions of this, or of the peroxide of hydrogen, may be administered.
The after effects must be met with stimulants, tonics and restoratives as are indicated.
In the treatment of chronic poisoning, the patient must be entirely removed from the cause, and restoratives as indicated used. Elimination is essential. The kidneys should receive much attention, and if not diseased should be stimulated to free activity. Vegetable alteratives will be of much service.
Description—This acid is a colorless liquid, almost odorless, and with a strongly acid taste.
Glacial Phosphoric Acid is obtained from calcined bones by the action of sulphuric acid; it occurs as a white uncrystallized fusible solid, with a very sour taste and without odor. Sparingly soluble both in water and in alcohol.
Neither of the above forms of phosphoric acid are used in medicine to any great extent.
Dilute Phosphoric Acid is formed by the addition of three and one-half ounces, by weight, of phosphoric acid, to twenty-six and one-half ounces, by weight, of distilled water. This contains ten per cent of absolute orthophosphoric acid.
This process results in the formation of a colorless liquid, with powerful acid properties. It does not, however, possess the corrosive action of other mineral acids.
Physiological Action—This agent in its physiological action resembles phosphorus only in a general way. It is a stimulant and sedative to depressed irritable nervous conditions when an acid is indicated in the system. It allays pain and distress of a subjective character probably more or less imaginary, present with hysterical conditions, and also in irritable patients suffering from nervous exhaustion.
Therapy—The agent is an excellent remedy for the so-called nervous dyspepsia. It adds tone to the nervous structure of the stomach, digestive and assimilative organs, materially aiding these functions. Its influence as a nerve sedative and tonic may be partially due to this stimulating influence over general nutrition.
If the characteristic indications present are those of an excess of acids, the excess is probably that of hydrochloric acid which may be neutralized before the phosphoric acid is given, when the latter agent will at once assist in correcting the gastric fault and will improve the condition of the nervous system.
Von Martinetz writes me that any case of debility, weakness, and lack of vitality may be corrected by this remedy, because the brain and the nervous system are directly influenced.
He says: "In the ulcerative stage of syphilis, I give phosphoric acid, and with the best results. In rheumatism, the acid, in certain cases, is a most excellent remedy, and if its indications are present, it will cure where other remedies fail."
"When I meet cases that require arterial sedatives in high temperatures, I give gelsemium, rhus tox, and bryonia, if these are indicated, and later I give the patient full doses of phosphoric acid. Sometimes I give these two classes of remedies alternately every two hours.
"In osteomalacia, or softening of the brain, phosphoric acid has a directly beneficial effect, superior to other treatment because its combinations directly build up the bone structures. I saw in the hospitals of Prague, under Professor Taks, many cases that had been treated with no result, which improved rapidly under phosphoric acid."
"A lady patient had spinal trouble, and became very weak. Finally I placed her on phosphoric acid treatment, and in the shortest time possible she made a permanent recovery."
Phosphoric acid stimulates the sexual function, increasing the tone of the ovaries and testicles, overcoming in some cases spermatorrhea. It corrects certain abnormal urinary sediments, rendering insoluble phosphates soluble, and easy of elimination.
Given in the manner advised for aromatic sulphuric acid in low forms of fever or in violent inflammatory fevers, with typhoid symptoms, it not only acts as a stimulant to the functions of nutrition, but it apparently increases nerve force. This fact is most important. It thus increases the force of the heart's action, giving strength and volume to the pulse. In none of these effects, however, it is quite equal to phosphorus, properly administered.
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.