It is well to consider the specific use of alkalies in this relation; as they are the opposite of acids. We may say of these, as of acids, that their deficiency is found as a constituent element in all forms of disease—in some cases being the basis of a morbid action, in others but a complication; but, whenever found, an important element and demanding direct treatment.
The symptoms of deficiency of these salts of the blood are very plain, and, using the language of the Prophet, "He who runs may read." The tongue is pallid and broad, its coating pasty and white, or yellowish white. The mucous membranes are uniformly pallid. As these evidences are absolute and readily determined, it is not necessary to name others not so constant.
Whenever we find this deficiency of the alkaline salts we will observe, as .the result loss of power in the stomach, enfeebled digestion and slow absorption, impairment of the circulation, arrest of nutrition and waste, and enfeebled innervation. These will correspond in degree to the deficiency.
So marked are these results, that I have long regarded the diagnosis, with regard to excess or deficiency of the alkaline salts, as of the highest importance. Indeed in some forms of disease, especially of a typhoid character, it is the principal element upon which a successful treatment is based.
Soda is the natural salt of the blood, and exists in the body in the largest proportion. Whenever, therefore, we have the evidence of deficiency of the alkaline salts, and no special symptoms indicating others we will give a Salt of Soda. In many cases I order Bicarbonate of Soda in water, in such quantity that it will make a pleasant drink, and let the patient have it freely.
If, at the same time, we wish an antiseptic influence, we may give the Sulphite or Hoposulphite of Soda or the Chloride of Sodium.
I am satisfied that I have seen patients die from deprivation of common salt during a protracted illness. It is a common impression that the food for the sick should not be seasoned, and whatever slop may be given, it is almost innocent of this essential of life. In the milk diet that I recommend in sickness, common salt is used freely, the milk being boiled and given hot. And if the patient can not take the usual quantity in his food, I have it given in his drink. This matter is so important that it can not be repeated too often, or dwelt upon too long.
The most marked example of this want of common salt I have ever noticed has been in surgical disease, especially in open wounds. Without a supply of salt the tongue would become broad, pallid, puffy, with a tenacious pasty coat, the effusion at the point of injury serous, with an unpleasant watery pus, which at last becomes a mere sanies or ichor. A few days of a free allowance of salt would change all this, and the patient would get along well.
A Salt of Potash is indicated where there is feebleness of the muscles to greater extent than can be accounted for by the disease. Occasionally such want is expressed in a marked manner by feebleness of the heart.
Ammonia will, occasionally, prove the best salt for temporary use, especially where there is great debility. But when so used, it should be followed by the free use of common salt, or some salt of soda.