Cuprum

Copper

Copper. Cuivre, Fr.; Kapfer., Ger.

Cupri Acetas

Copper acetate. (Not official.) Deep-green, prismatic crystals, yielding a bright-green powder, efflorescent on exposure to air, odorless, having a nauseating, metallic taste and an acid reaction. Soluble in 15 parts of water, and in 135 parts of alcohol at 60° Fahr. Dose, gr. -1/10—gr. 1/4.

Cupri Sulphas. Copper Sulphate.

Copper sulphate. Blue vitriol. In blue crystals, slightly efflorescent in the air, and soluble in 2·6 water at 60° Fahr. Ammonia throws down from the solution a precipitate, which is wholly dissolved when the alkali is added in excess. Dose, gr. 1/6—gr- ss.

Cuprum Ammoniatum

Ammoniated copper. (Not official.) A deep, azure-blue powder, having an ammoniacal odor, and a styptic, metallic taste. It is soluble in water. Dose, gr. 1/6—gr. j.

Antagonists and Incompatibles

Alkalies and their carbonates, lime-water, mineral salts (except the sulphates), iodides, and most astringent vegetables, are chemically incompatible with the salts of copper. In cases of poisoning, white of eggs and milk should be given freely, but evacuation of the contents of the stomach is necessary, for the albuminate of copper is not devoid of toxic power. The most effective chemical antidote is said to be the ferrocyanide of potassium, forming the insoluble ferrocyanide of copper. Magnesia has also been proposed, but it should not be relied on to the exclusion of albumen and ferrocyanide of potassium, nor should any antidote be used without evacuating the stomach contents by emetics or the stomach-pump.

Synergists

The salts of lead, tin, zinc, mercury, silver, gold, favor the therapeutic action of the copper-salts. All of these agents agree in this: they promote waste, and affect the functions of the nervous system secondarily. All unfavorable hygienic conditions, which depress the functions of the body, increase the activity of the copper-salts.

Physiological Actions

The salts of copper have a styptic, metallic taste. When a poisonous dose of a copper-salt has been taken the following symptoms, referable to the digestive organs, appear: A strong metallic taste, burning and constriction of the throat, increased flow of saliva, burning pain at the epigastrium, with griping and colic-pain of the intestines, nausea and vomiting. The vomited matters have usually a bluish or greenish color, and the intestinal evacuations, which begin in a few minutes after the poison has been swallowed, are dark-greenish and frequently bloody. These are the symptoms produced by the irritant poisons, and have no special characters, except, it may be, the color of the evacuations. The salts of copper, being diffusible substances, quickly enter the blood, and the systemic symptoms which follow are referable to the nervous system and the organs of excretion. In the blood, as is the case with the other metallic poisons, copper probably exists in the form of an albuminate in close relation to the red blood-globules. The breathing becomes short, hurried, and labored; the pulse small, quick, and weak; the skin cold and perspiring, and restlessness, headache, trembling, cramps, vertigo, and stupor, are followed by convulsions (clonic or tetanic), paralysis, and insensibility.

Inhalation of cupreous fumes, as in certain occupations in the arts, the slow introduction of small quantities, as occurs sometimes from cooking acid fruits in copper vessels, or the prolonged medicinal administration of moderate doses of a copper-salt, will produce the symptoms of chronic or slow poisoning. When inhaled, the symptoms first observed are those of bronchial irritation and bronchial catarrh (Hirt). Internally administered, a gastro-intestinal catarrh is produced, epigastric pain is experienced, nausea, vomiting, colic, tenesmus, and dysenteric discharges, and complete anorexia occur. The loss of appetite, and the interference with digestion, as well as the injury done to the red blood-globules, impair the strength and increase the waste of the tissues. A purplish line along the margin of the gum has been observed, salivation and ulceration of the gums not infrequently occur, and occasionally jaundice is present as one of the symptoms. As regards the nervous system, headache, muscular trembling, paresis of the limbs, and sometimes paralysis, altered sensations, defects of co-ordination, impaired mind, result. These nervous symptoms, with bronchial and gastro-intestinal catarrh, are usually grouped together in the case of chronic cupreous poisoning in artisans.

Copper is eliminated by the liver, intestinal canal, salivary glands, and kidneys. As is the case with the other metallic poisons, copper tends to accumulate in the liver.

Therapy

The sulphate of copper is one of the remedies sometimes effective in the vomiting of pregnancy. For this purpose not more than one twentieth of a grain, three times a day, is admissible. Rx, Cupri sulphat., grs. ij; aquae destil., oz ss. M. Sig.: Six drops a dose.

As sulphate of copper is a very prompt and effective emetic, it is frequently resorted to in cases of narcotic poisoning. Rx Cupri sulphat., grs. vj; aquae destil., oz ij. M. Sig.: A tablespoonful every fifteen minutes until vomiting ensue. It may be used under the same circumstances, but is by no means so desirable an emetic, in croup, as subsulphate of mercury. Minute doses of sulphate of copper render excellent service in gastro-intestinal catarrh, especially when the bowels are relaxed. Rx Cupri sulphat., gr. j ; ext. nucis vom., grs. iv. M. Ft. pil. no. xvj. Sig.: One three times a day before meals. When the food taken gives rise to colic, which is quickly followed by the inclination to stool, there should be combined with the above prescription one grain of morphine sulphate. When the constipation coexists with intestinal catarrh, the following prescription is useful: Rx Cupri sulphat., gr. j ; ext. physostigmae, ext. belladonnae, ext. nucis vom., āā grs. iv. M. Ft. pil. no. xvj. Sig.: One pill, three times a day, before meals.

The sulphate of copper is a most useful remedy in acute dysentery. Rx Cupri sulph., gr. ss; magnesiae sulph., oz j; acid, sulph. dil., 3 j; aquae, oz iv. M. Sig.: A tablespoonful every four hours. After the acuter symptoms have subsided, the sulphate of copper may be given with morphine and opium. Of all the metallic astringents employed for this purpose, sulphate of copper is the most effective in chronic diarrhoea and chronic dysentery. Rx Cupri sulphat., grs. j ; morphinae sulph., gr. j; quininae sulph., grs. xxiv. M. Ft. pil. no. xij. Sig.: One pill three times a day. Sulphate of copper is indicated when there are present colic-pains, tenesmus, and the stools, partly feculent, contain mucus streaked with blood. When tolerance is established, the quantity of copper in the above formulae may be increased slowly to one fourth of a grain. Rarely can more than one twelfth of a grain be given to an adult unaccustomed to its use, without causing very unpleasant nausea and depression.

The dysentery and cholera infantum of children, and the chronic entero-colitis which sometimes succeeds to measles, are often remarkably benefited by minute doses of sulphate of copper. Rx Cupri sul-phat., gr. j; tinct. opii deodor., gtt. viij; aquae destil., oz iv. M. Sig.: A teaspoonful every two, three, or four hours, for a child from one to two years of age.

The sulphate of copper is a useful palliative astringent in the diarrhoea of phthisis. It should be combined with opium.

Kissel regards the salts of copper as curative in pneumonia, and the preparation which he prefers is the tincture of the acetate (Phar.

Ger.). The mortality under this treatment was only 43 per cent. Ammoniated copper has been used recently with remarkable success in the treatment of facial neuralgia. It must be pushed (Féréol).

The salts of copper, especially the cuprum ammoniatum, are among the numerous remedies employed in the treatment of epilepsy, choreay and hysteria. Successful results have, it is true, been obtained by the use of these remedies, but at the present time they are rarely employed.

External Uses

The salts of copper do not act very energetically on the unbroken integument. Applied to wounds they are astringent—that is, they combine with albumen, contract the tissues, and coagulate the blood. A crystal of sulphate of copper may be used to arrest bleeding from small wounds, e. g., from leech-bites. Indolent ulcers with flabby granulations can be stimulated to a renewed and more healthy activity by touching the affected surface with a crystal of sulphate of copper, or by frequent application of a solution (grs. ij —grs. x— oz j). The following is an excellent injection in gonorrhoea after the acute stage: Rx Cupri sulph., grs. iv; morphinae sulph., grs. viij; liq. plumbi subacetat., 3 j ; aquae rosae, 3 iv. M. Sig.: As an injection. In that troublesome affection, granular lids, the sulphate of copper may be rubbed over the everted lid once a day with advantage. The application gives great pain, and is immediately followed by intense hyperaemia, which, however, subsides in a few hours, leaving the conjunctiva in much better condition than before.

In scabies, a solution of sulphate of copper (oz Oj) has been used with great success, the lotion being applied after the crusts have been thoroughly removed with soap and water. An ointment of acetate of copper (grs. x— oz j) is a very effective application in herpes circinatus (ringworm). The following formula has been recommended in menta-gra: Rx Cupri sulph., 3 j; zinci sulph., oz ss; aquae laur.-cerasi, oz jss; aquae destil. ad oz xvj. M. Sig.: Lotion. The acetate and carbonate of copper are very effective remedies in tinea sycosis. Rx Cupri carb., 3 ij; adipis, oz j. M.

Authorities referred to:

Hirt, Dr. Ludwig. Die Krankheiten der Arbeiter, erste Abtheilung, p. 79, et seq-Bre9lau, 1871.

Hermann, Dr. L. Lehrbueh der experimentellen Toxicologie, Berlin, 1874, p. 209

Gubler, Prof. Adolph. Commentaires Therapeutiques du Codex Medicamentarius, Paris, 1868, p. 435.

Nothnagel, Dr. Hermann. Handbuch der Arzneimittellehre, Berlin, 1870, p. 291.

Tardieu, Ambroise. Dietionnaire d'Hygiéne Publique et de Salubrité, deux, edition. Paris, 1862, vol. i, article Cuivre.

Taylor, Dr. A. S. On Poisons, p. 458, et seq.