Sulphurated potash (hepar sulphuris, or "liver of sulphur") (v. Potash) and sulphide of calcium (hepar calcis, or "liver of lime") are in common medical use, and the sulphides of sodium and of ammonium are found in many of the sulphurous mineral waters. Their action is somewhat similar to that of sulphur, perhaps more powerful. The sulphide of calcium (not officinal) is found native, or may be prepared artificially by calcining, in a closed vessel, equal parts of sublimed sulphur and pulverized oyster-shell (a pure form of lime carbonate). It is a yellowish white powder of sulphurous taste and odor. Hypochloride of sulphur consists of "flowers of sulphur" impregnated with a small quantity of chloride of sulphur (S2Cl2) obtained by passing chlorine over sulphur. It is apt to explode if kept in full glass bottles closely corked.

Preparations And Doses

Pure precipitated sulphur is more finely divided, and is thought to be more active, than the sublimed form; the dose of either is, however, the same, 5 to 10 gr. as a stimulant, 20 to 60 gr. as a laxative; it is well given in milk, honey, or treacle. Confectio (made with sublimed sulphur): dose, 60 to 120 gr. Unguentum contains 1 part to 4 of benzoated lard. A milder and often more useful form of ointment is made with half the amount of sulphur and 1/2 dr. of carbonate of potash to the ounce; essence of lemon conceals the odor (Squire). Solutio calcis c. sulphure may be prepared by boiling together 1 oz. of quick-lime and 5 of sublimed sulphur in 1 pint of water for half an hour; filter, and make up, if necessary, to half a pint; a similar solution is now commonly sold by wholesale chemists. Lotio potassoe sulphuratoe may be prepared with 1 dr. to half a pint of water for use in irritable skin eruptions. Balneum potassoe sulphuratoe: 1/2 lb. to 30 gallons of water, in porcelain or wooden vessel. Balneum sulphuris compositum (Star-tin): precipitated sulphur, 2 oz.; hyposulphite of soda, 1 oz.; dilute sulphuric acid, 1/2 fl. oz.; water, 1 pint: to be added to 30 gallons of water. A sulphur vapor bath may be prepared by evaporating 1/2 oz. to 2 oz. of the solution of lime and sulphur by means of a spirit-lamp placed under a suitable arrangement of chair, coverings, etc.; the face should be protected from the vapor (Medical Times, i., 1870, p. 308).

[Preparation, U. S. P. - Unguentum Sulphuris: sublimed sulphur, 1 troyounce; lard, 2 troyounces.]

Adulterations

The precipitated sulphur commonly sold, especially before the passing of the Adulteration Act, contained a large proportion of sulphate of lime; this was due to the employment of sulphuric acid instead of the hydrochloric acid ordered in the Pharmacopoeia; but, as some excuse, it may be mentioned that a former London Pharmacopoeia contained a preparation made with sulphuric acid, and known as "milk of sulphur." This name has now been transferred as a synonym to the modern "precipitated sulphur," and hence has arisen much confusion and even litigation. Druggists have been prosecuted for supplying the lime compound when asked for "milk of sulphur," and although convicted by some magistrates of offences against the Act, the convictions have mostly been quashed on appeal to a higher court, on the ground that "milk of sulphur" is known by trade custom to be a distinct thing from the pure precipitated form. It is desirable that this should be particularly understood (British Medical Journal, i., 1877; Lancet, i., 187G, p. 936). As a rule, a pure preparation may be obtained by asking for that of the British Pharmacopoeia. An adulterated specimen is whiter, with only slight yellowish tinge, and when pressed looks silky and glistening; under the microscope, crystals may be seen in thin tables or elongated prisms, and on exposure to a red heat, lime is left as a white ash (Medical Times, i., 1853). Washed Sicilian sulphur is nearly always pure, but that prepared from pyrites often contains arsenic.

Absorption And Elimination

It has been stated, though not satisfactorily proved, that finely divided sulphur may pass as such into the blood. Eberhard states further that he has seen it in the lymphatics, and Griffith that he has found it excreted in the urine, but these statements lack confirmation, and are not easy of credence.

It is more probable that, before absorption, under the influence of alkaline saliva and mucus, and the secretion of intestinal glands, an alkaline sulphide is formed, part of which is decomposed in the intestine (the resulting sulphuretted hydrogen being passed as flatus), and part oxidized, since its administration increases the urinary sulphates (Regensburger: Centralblatt f. Med., 1877). Of any ordinary dose of sulphur, a certain proportion passes out unchanged and unabsorbed in the faeces. Fatty substances are said to promote absorption of sulphur, though the experiments of A. Krause (1853) scarcely support this view. He found that when equal doses of sulphur were given, either with or without fat, the amount of sulphates excreted by the urine was the same.

The sulphuretted hydrogen which is absorbed is eliminated by the skin, the bronchial membrane, and by the various glands, and gives indication of its presence, both by its odor and by staining silver articles worn about the person. Orfila detected it in the urine.

In exceptional cases the gas may be formed in, and absorbed from, the intestine with production of marked but temporary nerve-depression. I have not myself seen this as an effect of taking sulphur medicinally, and in cases where sulphuretted hydrogen has been injected into veins it has been so quickly eliminated by the lungs that the arterial current remained unaffected by it (C. Bernard). Dr. B. W. Richardson concluded, from observations with "sulphur alcohol," that its compounds were not absorbed from the alimentary canal, but I believe that occasionally they may be so. In aged persons, and in some cases of hepatic and intestinal disorder, I have noticed attacks of depression coincident with flatulence and foul breath, and relieved by a stimulating purge; and Dr. Senator has recorded the case of an adult suffering from gastric catarrh, in whose breath and urine sulphuretted hydrogen had been detected, and who had more than one attack of collapse lasting for a few minutes and accompanied with pallor, giddiness, and small, quick pulse; he recovered after purgation (Berlin. klin. Woch., 1868, No. 24).

Physiological Action (External)

Applied with friction to the sound skin, sulphur causes a moderate degree of irritation; much more if the surface be excoriated. The alkaline sulphurets, such as those of potash and of lime, irritate severely, if used in strong and warm solution, to a delicate skin. Sulphur and some of its compounds have the power of destroying the lower forms of vegetable and even animal life; whence their practical value as "anti-zymotic and anti-parasitic" remedies. Binz attributes this power to the formation of sulphurous acid under the influence of exposure to the air, and to heat, and to contact with protoplasmic organisms (e.g., the oidium Tuckeri of the grape). The subject of disinfection is more fully considered under the heading of Sulphurous Acid.

Physiological Action (Internal)

Given to animals it produces at first, at least, some stimulant effect. Benk states that its after-effect is of reverse character, and that this is accompanied by, and is probably due to, intestinal irritation. Hertwig found also that animals were readily brought under the influence of the drug with production of diarrhoea.

Circulatory System

Sulphur and the sulphides, in moderate doses, stimulate the circulation, especially that of the capillaries, the skin and mucous membrane, and the venous circulation within the pelvis. Congestive headache, vertigo, and sometimes hemorrhage have been traced to the use of the drug and of mineral waters containing it. Gubler, Mitscherlich, and many older authorities are agreed upon these points, and assert further that a rise in temperature and distinct pyrexia may be caused by sulphur, especially in plethoric persons.