Phosphorus has been used in osteomalacia, in rickets, and in cases of ununited fracture. Without doubt it promotes calcareous deposit in the healing of fractures. It is of value in the convalescence from exhausting diseases, in nervous exhaustion, in neuralgia when dependent upon debility, in alcoholism, in sexual exhaustion and in various suppurative diseases.

Toxicology

Acute Poisoning

Phosphorus is often taken or administered criminally, either as match-heads or vermin paste.

Symptoms

For the first few hours there are no effects, then the following symptoms of gastro intestinal irritation set in: Nausea, abdominal pain, and vomiting; the vomited matters smell of phosphorus and are luminous, if heated with sulphuric acid (Wood). There is some general depression. Diarrhoea is rare. The patient may die in collapse, but far more frequently these symptoms all pass off, and he appears quite well. But after three or four days jaundice is noticed, and this soon becomes very marked; there is now great prostration, the liver is enlarged, the abdomen distended, and he complains of intense thirst. There is likely to be a garlicky odor to the breath. (Brunton, Semple). Vomiting of altered blood and diarrhoea with bloody stools may be observed, but these two symptoms are not severe. The skin is cold, the pulse feeble and rapid. The urine is scanty, highly colored, albuminous, bile-stained, and perhaps bloody, and it may contain bile acids and crystals of leucin and tyrosin. Sarcolactic acid found in the urine is diagnostic. (Wood). Muscular twitchings occur, the patient becomes comatose and dies. Post-mortem. - Two results are very striking. (1.) Fatty degeneration (thus phosphorus resembles arsenic and antimony), affecting principally the liver, in which it is very marked; and if the patient lives long enough, there may be a diminution in the size of the organ. Fatty degeneration is also found in the muscles, kidneys and gastro-intestinal tract. (2.) Haemorrhages are seen in many places, and ecchymoses are sometimes very abundant. If they occur in the gastric and intestinal mucous membranes, they may give rise to the erroneous belief that evidences of acute gastro-intestinal irritation can be found at death. The symptoms of phosphorus poisoning in many respects resemble those of acute yellow atrophy of the liver.

Treatment

Thoroughly empty the stomach by a stomach pump, or by washing it out. Formerly copper sulphate was given as an emetic {see Copper, p. 180), three grains .20 gm. every few minutes till vomiting is induced, then every 15 minutes; also half a drachm 2. c.c. of oil of turpentine every half hour. A full dose of a saline purge may be administered. Repeated and free inhalations of oxygen have been used, which suggest that hydrogen dioxide may be efficacious when given by the mouth. No oils or fats should on any account be given. Percy found that the old oil of turpentine, which contains oxygen, if administered soon after taking the poison and before it was absorbed, was an antidote (experiments upon dogs).

Chronic Poisoning

This, which used to be seen in those who worked among phosphorus fumes, is now of great rarity. This is because the red or non-poisonous phosphorus is generally employed in match factories. The chief symptoms are those of gastrointestinal irritation and necrosis of the jaw. This Stockman has shown to be due to the fact that the phosphorus fumes, when the gum is broken, gain access to the bone and lower its vitality, so that it easily becomes the seat of tuberculous disease. Sufferers from phosphorus necrosis often die from general tuberculosis.