This section is from the book "A Text-Book Of Materia Medica, Pharmacology And Therapeutics", by George F. Butler. Also available from Amazon: A text-book of materia medica, pharmacology and therapeutics.
Treatment of Poisoning. - This should be prompt. The cautious administration of alkalies is indicated to neutralize the acid, though the evolution of carbonic-acid gas resulting from some may rupture the stomach. The stomach should be washed out, and this treatment followed by demulcent drinks and oil, milk, and eggs. Opium may be necessary for the relief of pain, and brandy or whiskey subcutaneously in case of collape.
Therapeutics. - Externally and Locally. - Hydrochloric acid is employed as a caustic in noma and putrid sore throat. Mixed with two or three parts of honey, it is an efficient application to the throat in diphtheria. Andrews and Morris have recommended diluted hydrochloric acid for the removal of sequestra, and Chas-saignac has utilized the acid in removing necrosed bone in osteitis and caries.
Nitric acid is a much more powerful caustic, and as such is used more extensively than any other mineral acid, because of its limited action and the ease with which it is controlled. It is an excellent caustic in cases of cancer of the cervix, venereal warts, hospital gangrene, phagedenic ulceration, hemorrhoids, and prolapse of the rectum, especially in the case of children. In cases also of fungoid granulation and excessive hemorrhage from the uterus it has been highly recommended. In certain diseases of the throat, nose, and ear this acid has been used for the destruction of growths, as well as for its escharotic action in ulcerated conditions.
Dermatologists find nitric acid to be an efficient application for the removal and destruction of epithelioma, moles, nevi, chloasma, etc., caution being exercised in the latter case merely to produce an exfoliation of the skin, not sufficient destruction of tissue to result in a cicatrix.
Liveing recommends a very weak solution of nitric acid with tincture of opium in pruritis.
Phosphoric acid, in the strength of 50 grains (3.2 Gm.) to the ounce (30.0 Cc.) of distilled water, has been suggested by Grossich in the treatment of scrofulous ulcers, and an injection of this solution into tuberculous glands of the neck is highly recommended by the same authority.
Sulphuric acid is perhaps the most persistent, irritating, and destructive caustic known. Its affinity for water, and its consequent extensive action, render it, when used alone, unfit for caustic purposes. Mixed with powdered charcoal, however, it forms a paste which is an efficient caustic application to chancres, cancers, etc. Frazer considers the strong sulphuric acid the best caustic in the bites of rabid animals. Diluted solution, in the proportion of 6 parts of the strong acid to 4 parts of diluted alcohol, has been recommended for epistaxis.
The eschar formed by the three chief mineral acids is of diagnostic interest. Sulphuric acid, brown to black; nitric acid, yellow; hydrochloric acid, white to grayish-white.
Internally. - Hydrochloric acid, being a normal constituent of the stomach, is indicated in certain forms of gastric dyspepsia, particularly in the atonic variety. In these latter cases there is usually decomposition and fermentation of food, which condition is greatly relieved by the administration of pepsin or hydrochloric acid after meals, or the same with bitters before meals.
In intestinal indigestion hydrochloric acid is an admirable remedy, given one to two hours after meals.
The diluted hydrochloric acid is a useful remedy in the treatment of typhoid. It allays thirst, moistens the tongue, aids digestion and exerts an antiseptic influence in the bowels, thereby lessening the flatus.
In certain affections of the skin dependent upon deranged digestion, hydrochloric acid often proves a potent remedy.
Nitric acid has been used for the same purposes as hydrochloric acid, although for digestive disorders it is inferior to the latter drug.
In intermittent and periodical fevers, however, nitric acid is an efficient remedy. In hepatic disorders the diluted nitrohydrochloric acid deservedly holds a high place as a remedial agent, and the same remedy is frequently employed with success in chronic syphilis, but solely by reason of its improving the appetite.
In the conditions known as oxaluria and lithemia nitric and nitrohydrochloric acids serve an excellent purpose.
The aphonia of singers and public speakers is often relieved by the diluted nitric acid, certain cases of bronchitis being also benefited by the same remedy.
Phosphoric acid has acquired some reputation as a remedy in anemia and as a tonic in wasting diseases and neurasthenia. Its value, however, is based more upon hypothesis than upon the results of clinical observation.
Possibly phosphoric acid is superior to the other mineral acids only in its action in diabetes, in which disease it certainly possesses a remarkable influence in diminishing thirst and lessening the secretion of urine.
Sulphuric acid is inferior to nitric or nitrous acid in serous diarrhea. It is nevertheless an invaluable, as well as an old and tried, remedy in cholera.
This remedy also deserves favorable consideration in the treatment of acute lead-poisoning. Moreover, in chronic lead-poisoning water acidulated with sulphuric acid makes an efficient prophylactic, and the remedy has also been suggested as a preventive of Asiatic cholera.
Owing to its astringent and antiseptic properties this acid, particularly the aromatic sulphuric acid, proves a good remedy in certain cases of diarrhea. It is especially valuable in limiting the sweating in phthisis.
In scurvy and purpura, sulphuric acid has proved valuable, and it has been recommended as an internal remedy in lichen, prurigo, and many itching diseases of the skin.
Contraindications. - Acute inflammation of the stomach, rheumatism, gout, and where the urine is excessively acid and of high specific gravity.
Administration. - Only the diluted acids should be given internally, and even these should be further diluted, and taken, if possible, through a glass tube, to prevent injury to the enamel of the teeth. They are best given after meals, and should not be administered for too long a period; and the first indication of untoward action, such as griping, diarrhea, etc., is to be taken as a warning that the drug must be withdrawn.
 
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