This section is from the book "Materia Medica And Therapeutics: An Introduction to the National Treatment of Disease", by John Mitchell Bruce. Also available from Amazon: The pharmacology and therapeutics of the materia medica.
Antimonium Nigrum. - Black Antimony. Native Sulphide of Antimony. Sb2S3
Source. - Purified from siliceous matter by fusion, and powdered.
Characters. - A metallic-looking powder, of a steel-grey colour.
Impurity. - Silica; insoluble in boiling IIC1.
Not given medicinally.
From Antimonium Nigrum are made: a. Antimonium Sulphuratum. - Sulphurated Antimony. Sulphide of Antimony, Sb2S3, with a small and variable amount of Oxide of Antimony, Sb2O3.
+ 3H1O. (2) 2Na3SbS3 + 3H1SO4 = Sb2S3 + 3Na2SO4 + 8H1S.
Characters. - An orange-red powder, without odour, and with, a slight taste, insoluble in water.
Impurities. - General; detected volumetrically.
Dose. - 1 to 5 gr.
Antimonium Sulphuratum is an important ingredient of Pilula Hydrargyri Subchloridi Com-posita. 1 in 5. (See Mercury.) b. Liquor Antimonii Chloridi. - Solution of Chloride of Antimony, SbCl3, in Hydrochloric Acid. "Butter of Antimony."
Source. - Made by dissolving Black Antimony in Hydrochloric Acid. Sb2S3 + 6HC1 - 2SbCl3 + 3H1S.
Characters. - A heavy yellowish-red liquid, giving a white precipitate with water.
From Liquor Antimonii Chloridi is made:
Antimonii Oxidum. - Oxide of Antimony. Sb2O3.
Source. - Made by (1) precipitating Oxychloride of Antimony, by pouring the Solution of the Chloride into Water; washing; and (2) adding Carbonate of Soda Solution. (1) 12SbCl3 + 15H1O = 2SbCl3 5Sb2O3 + 30HC1. (2) 2SbCl35Sb2O3 + 3Na2CO3 = 6Sb2O3 + 6NaCl + 3CO2.
Characters. - A greyish-white powder, insoluble in water.
Imparities. - Higher oxides, insoluble when boiled with acid tartrate of potash.
Dose. - 1 to 4 gr.
Preparation. Pulvis Antimonialis - "James's Powder."
1, with 2 of Phosphate of Lime. Dose, 3 to 10 gr.
From Antimonii Oxidum is made:
Antimonium Tartaratuni. - Tartarated Antimony. Tartar Emetic. KSbC4H4O7.H1O.
Source. - Made by boiling Oxide of Anti-mony with Acid Tartrate of Potash, and crystallising. 2KHC4H4O6 + Sb2O3 = 2KSbC4H4O7 +H1O.
Characters. - Colourless transparent crystals, exhibiting triangular facets. Solubility, 1 in 20 of cold water; 1 in 2 of boiling water.
Impurities. - Cream of tartar, and iron; detected volumetrically, and by solubility.
Dose. - As a diaphoretic, 1/16 to 1/6 gr.; as an emetic, 1 to 2 gr.
(1) Unguentum Antimonii Tartarati. -1 to 4.
(2) Vinum Antimoniale. - 2 gr. in 1 fl.oz. Dose, 5 min. to 1 fl.dr.
Externally. - Antimony, in the form of the Liquor Anti-monii Chloridi, is a escharotic, employed chiefly in veterinary practice, occasionally by the surgeon as an application to poisoned, foul, or malignant surfaces. Tartarated Antimony applied to the skin, either in aqueous solution or as the officinal ointment (half a drachm at a time, repeated), causes a pustular eruption, and was once used as a counter-irritant in diseases of the lungs, joints, or meninges. Antimony is freely absorbed from the broken skin, and from mucous surfaces.
Internally, the local effect is equally irritant. In doses of 1 to 3 grains tartarated antimony is an emetic, whence its popular name. The effect is partly direct - due, that is, to the irritant action of the drug upon the walls of the stomach; partly indirect, from immediate stimulation of the vomiting centre in the medulla. Further, its direct effect on the stomach is produced not only when the salt is admitted to it by the mouth, but when it reaches the stomach by the blood, that is, when it is being excreted by the gastric mucosa. Thus, whilst tartar emetic induces vomiting most quickly when swallowed, it is not speedy and evanescent in its effects, but induces both previous and subsequent nausea and depression. It is not suited, therefore, for use in cases of poisoning, where rapid evacuation is of the first importance, or where there is much general depression; but is useful in the first stage of acute inflammatory diseases with sthenic fever, in strong healthy subjects. It is especially indicated in respiratory affections, such as laryngitis and bronchitis, where its; remote effects as an expectorant are valuable; or to clear the air-passages in the same diseases or in whooping cough.
In smaller continued doses the local action of tartarated antimony on the stomach and bowels is apt to produce loss of appetite, nausea, pain, and diarrhoea.
Antimony enters the blood either from within or from without, but does not appear to combine with the albumen of the plasma. No special action or use has to be mentioned under this head.
Having reached the tissues and organs, antimony clings to them with some tenacity, and may be found in them months after its administration. Here it sets up a series of important changes, attended by phenomena referable to the general nutrition of the body, the circulation, respiration, and nervous and muscular systems; besides the effects to be afterwards described as referable to its excretion.
The effect of antimony on metabolism closely resembles that of phosphorus and arsenic, to the account of which the student is referred. Briefly the principal results are fatty degeneration of the organs and increase of the nitrogenous products, oxygenation being comparatively deficient. Upon this alterative effect depends in part the value of antimony in gout, chronic skin disease, etc., to be afterwards described. The heart is depressed from the first by tartarated antimony. Even in small doses it reduces the strength, and very soon the frequency of the pulse, which tends to become irregular, and fainting may occur; the whole being referable to a direct action upon the nervo-muscular substance of the heart. Antimony is thus a powerful circulatory depressant. The respiratory movements are also weakened and disturbed by this drug, which causes shortness of inspiration and lengthening of expiration, manifestly a degree of the same disturbance which culminates in vomiting, and allied to the process of expectoration. The nervous system is markedly depressed by antimony, in part directly, in part indirectly through the circulation, the effect of a moderate dose being to produce a sense of languor, inaptitude for mental exertion, lowness, and sleepiness. Tartarated antimony has accordingly been used as a sedative in the delirium and insomnia of fevers, such as typhus, and acute alcoholism (delirium tremens), combined with opium in various proportions.
The muscular system is so powerfully depressed by antimony that, before the introduction of chloroform, it was employed to produce muscular relaxation in the reduction of herniae and dislocations. Nauseating and emetic doses cause great weakness of the voluntary movements, inability to stand, occasional tremors, and aching of the muscles. It is still given as an antispasmodic, to relax the cervix uteri in some classes of difficult labour, and in combination with purgative medicines to prevent or remove spasm of the bowel.
Antimony leaves the system by all the mucous surfaces, the liver, kidneys, and skin; so that it may cause inflammation, salivation, and pustulation of the mouth, oesophagus, and stomach when administered by the skin. In being excreted by the stomach, it produces there, as we have seen, a remote emetic effect. Its excretion in the bile constitutes it a hepatic stimulant, sulphurated antimony, either as Plummer's pill or alone, being much esteemed as a cholagogue, especially in gout and loaded conditions of the liver. In passing through the kidneys, it has a slight diuretic action. In doses of 1/10 to 1/5 gr., it stimulates the skin, acting as a diaphoretic, of service, as we shall see, in feverish conditions. Its internal use occasionally develops the characteristic pustular eruption, which suggests it as a remedy for certain forms of chronic skin disease. Antimonial wine is a familiar sedative expectorant, apparently from the excretion of the drug by the respiratory surfaces, given with great advantage in the first stage of acute bronchitis in strong subjects, less frequently in acute pneumonia.
When the various effects of antimony thus detailed are reviewed together, it is found to be a powerful general depressant, oxygenation being impaired, nervo - muscular activity reduced, the heart weakened, and the waste of the body increased through all the channels of excretion, and by loss of heat. When a full dose (1 to 3 gr.) is given, and vomiting induced, this general depression may threaten to pass into collapse, with pallor and coldness of the surface, and marked fall of the body temperature. On this account tartarated antimony may sometimes be employed with benefit as an antipyretic or febrifuge at the comment tnunt of acute febrile attacks in sound robust subjects, more especially bronchitis, where the attendant increase of the bronchial secretion will be serviceable, and the possible emesis by no means contra-indicated. Great caution must, however, be exercised in prescribing this powerful depressant, and the best method of administering it is in very small doses in water everv fifteen or thirty minutes, until the skin becomes moist and cool, when it may be stopped.
The unquestionable value of Plummer's Pill would appear to be partly referable in the same way to the action of antimony not only on nutrition, but on the various organs of elimination, including the skin and the kidneys.