Absorption and Elimination. - The potassium salts possess very high diffusive power. They are easily and quickly absorbed and rapidly excreted, the salts with vegetable acids being eliminated as alkaline carbonates, rendering the urine alkaline. Salts of potassium are chiefly eliminated by the kidneys, though the process takes place to some extent through the bronchial mucous membrane and other secretions. They are active diuretics, increasing the amount of water and, by stimulating the renal epithelium, augmenting the excretion of solids. The uric acid is greatly diminished, being converted into urea, and as such eliminated, showing that the alkalies increase oxidation and promote catabolism.

Temperature. - Medicinal doses have no effect upon temperature.

Untoward Action. - Under prolonged dosage the digestion becomes impaired. There is present paralysis of the muscular fibers of the intestines, accompanied by diarrhea or constipation and tym-panities. There may be also present emaciation, muscular weakness, nervous prostration, and anemia.

Poisoning. - The caustic preparations of sodium and potassium produce the symptoms of the corrosive poisons, resembling the poisonous action of the mineral acids to be described. Death is occasionally preceded by convulsions, the heart's action being arrested before respiratory failure. The carbonates and bicarbonates and the salts of vegetable acids are not considered poisonous, nor do they produce the corrosive effects of caustic potash or its solution.

Treatment of Poisoning. - Vegetable acids are chemically incompatible, and should be given freely, together with oils and demulcent drinks as protectives, and opium, if necessary, to relieve pain. Cardiac stimulants - digitalis, brandy, caffeine, etc. - may be required to sustain the heart, to be given hypodermically.

The Comparative Action of the Alkalies. - Sodium salts in their action are analogous to potassium, although less irritating to the gastro-intestinal tract. They are also less depressing to the circulatory, muscular, and nervous systems.

Lithium salts closely resemble in their effects those of potassium, their action upon the nerves and muscles, however, being less powerful. The contractile force of muscle is invariably diminished by lithium and increased by potassium. They are useless as lithium in gout. The large amount of water with which they are usually given is the most potent factor in lithium "gout" cures.

Calcium salts are more sedative and astringent in their action upon the gastro-intestinal tract than the other alkalies, and are direct antacids. They tend to produce constipation. The nervous and muscular systems are less affected by these salts than by the remaining alkalies, the contractile muscular force, however, being increased by calcium. They are less readily absorbed and excreted than the foregoing alkalies, and less active in increasing the alkalinity of the urine. They are useful heart stimulants.

Magnesium Salts. - Magnesia and the magnesium carbonates are direct antacids and sedatives to the stomach, acting upon the intestinal canal as saline cathartics. In their influence upon the circulatory system they are feebler than, but similar to, the potassium salts, slightly increasing the alkalinity of the blood. They are not so readily absorbed, nor so rapidly excreted, as the salts of potassium and sodium, while increasing the amount of water and solids excreted.

Ammonium Salts. - These preparations are used rather as cardiac stimulants, their physiological action being more extensively considered under that group. As antacids their action may be briefly compared with that of the other alkalies. Their effect upon the gastric juice and its secretion is similar to that of the carbonates and bicarbonates already mentioned. They dilate the blood-vessels of the stomach, augmenting the blood-supply and producing a sensation of warmth in the epigastrium. Lethal doses act as emetics. They increase the glycogenic function of the liver and stimulate the circulatory system, elevating the pulse-rate and raising arterial tension. In medicinal doses they stimulate the spinal cord, motor nerves, and muscles, while toxic doses paralyze these structures. They prevent the coagulation of the blood and lessen the oxygen-carrying power of the red corpuscles. By them also the respirations are increased in frequency.

The salts of ammonium are quickly absorbed and undergo oxidation in the body, augmenting the amount of uric acid and urea in the urine, thereby increasing its acidity to some extent.

As regards the poisonous activity of the alkalies mentioned, ammonium ranks, next to potassium, the most toxic of all.

Therapeutics. - Externally and Locally. - Norton has recommended liquor potass in ingrowing toenail, the solution being applied to the nail, which is soon rendered so soft that it can be easily scraped without causing pain. The same remedy is used in many diseases of the skin to allay itching and soften the horny epithelium. It is also employed extensively in diseases of the ear and throat, and in the proportion of I part to 10 parts of water it is very effective in softening impacted cerumen.

The potassium carbonate in solution is frequently used in various pruriginous diseases of the skin, being a highly efficient antipruritic.

The detergent and sialagogue properties of potassium citrate and tartrate are rendered serviceable in certain diseases of the mouth.

Sodium bicarbonate is a deservedly popular dressing for burns, and pain and swelling of the joints in acute articular rheumatism are sometimes greatly relieved by enveloping the articulations in a hot solution rendered alkaline with this salt. In diseases of the ear it is used for the same purposes as the potassium preparations above mentioned. It is one of the ingredients of "Dob-ell's Solution," which is an effective antiseptic wash in nasal catarrh, and the solution of sodium bicarbonate has been suggested as a valuable remedy in thrush or aphthae.