Latin, Phenol (Gen., Phenolis)

Eng., Phenol. Synonym, Carbolic acid. Formula, C6H5OH.

Obtained from coal-tar by fractional distillation and subsequent purification, or made synthetically.

Form

Colorless, needle-shaped crystals or crystalline mass, sometimes acquiring a reddish tint. This does not seem to impair its efficiency. It melts when heated, but recrystallizes at about 100° F.

Odor And Taste

A characteristic, somewhat aromatic odor. When well diluted with water, a sweetish taste with a slightly burning after-taste.

Solubility

In 15 parts of water. Freely soluble in alcohol, glycerin, oils, etc.

Incompatibles

Albumin, collodion, iron salts; when triturated with the following it yields a liquid or soft mass: acetanilide, acet-phenetidin, antipyrine, camphor, hydrated chloral, lead acetate, menthol, phenyl salicylate, resorcinol, sodium phosphate, thymol, terpin hydrate, and urethane.

Average Dose

1 grain (0.06 Gm.).

Official Preparations.

Phenol Liquefactum (Gen., Phenolis Liquefacti)

Eng., Liquefied Phenol. A liquid obtained by melting phenol and adding 10 per cent. of water. It contains not less than 87 per cent. of C6H5OH.

Form

A colorless liquid which may develop a slight reddish tint.

Odor And Taste

See Phenol.

Solubility

In 12 parts of water, miscible in all proportions with alcohol or glycerin. When diluted with an equal volume of glycerin it is miscible with water.

Incompatibles

See Phenol.

Average Dose

1 minim (0.05 mil).

Glyceritum Phenolis

Eng., Glycerite of Phenol. Liquefied Phenol, 20 mils; Glycerin, 80 mils.

Average Dose

5 minims (0.3 mil).

Unguentum Phenolis

Eng., Ointment of Phenol. Contains about 2 per cent. of Phenol.

Therapeutic Action

Antiseptic, germicide, local anesthetic, caustic, antiemetic.

Uses

Internally.-For nausea, diarrhea, dysentery, typhoid fever, etc. Locally.-For otitis media, ulcers, pruritus, endometritis, and various skin diseases. It is used for sterilizing instruments, excretions, etc.

Toxicology

Toxic amounts of liquefied phenol are frequently taken either through error or with suicidal intent. Among the symptoms are: Odor of the drug, the white areas around the mouth or on the mucous membrane of the mouth and throat, if patient is seen early. There may also be depression, collapse, weak pulse, lowered temperature, and smoky-colored urine. Vomiting may occur. Large amounts may cause prompt collapse and death. Treatment: The stomach should be washed out with, about a 20 per cent. solution of alcohol, then demulcents given and the patient stimulated with ammonia, strychnine, atropine, etc., as indicated. The body should be kept warm. It should be remembered that alcohol is an antidote to the local action of the drug, but does not prevent the absorption and systemic effects; so alcohol should not merely be administered, but removed (with the phenol) from the stomach. Poisoning has occurred from absorption from wet dressings containing Phenol.

Administration

In prescribing it is desirable for the sake of correctness to remember that Phenol is a solid, so should be prescribed in grains, and that when it is desired to prescribe by minims, Liquefied Phenol must be specified.

The former is the preparation that should generally be used in ointments, oily liquids, etc., while the latter is often the more convenient preparation for other solutions.

Unfortunate results have sometimes followed the prescribing of an excess of Phenol in an aqueous liquid. Not more than 5 per cent. should be ordered in water unless glycerin is used to facilitate solution. It has been claimed on good authority that it requires several hours for complete solution of Phenol in water to take place; so, if possible, it should be allowed to stand some time after mixing, before it is used.

Ointments should always be made by melting both the Phenol crystals and the vehicle, and effecting the solution while in this state. Unpleasant results have frequently followed the use of an ointment made by the cold incorporation of the Liquefied Phenol with Petrolatum or other fatty vehicles. Solution may not be effected, but small drops of the liquid distributed through the vehicle. Solution of the drug was at one time extensively used as a wet dressing and many cases of poisoning occurred, both local (as gangrene) and systemic, from absorption. When the solution is sufficiently strong to coagulate the proteids of the surface, absorption is retarded, but weak solution may admit of sufficient absorption to cause toxic symptoms. Some methods of using Phenol are shown in the following:

Solutions in water up to 5 per cent. may be ordered as:

M.

Sig

Apply as directed.

Solutions in water stronger than 5 per cent. may be ordered as:

M.

Sig

Apply as directed. (Shake-label.)

As a local application in otitis:

M.

Sig

Two (2) drops in ear twice daily if necessary.

As a local application, as for tonsillitis, etc.

M.

Sig

Apply as directed.

Used to allay itching in the treatment of smallpox:

M.

Sig

Use locally.

1 Musser and Kelly: Practical Treatment.

In the treatment of gonorrhea:

M.

Sig

Use as directed. (Not to be taken.)

Patient should be instructed to inject after urination. In the treatment of alopecia:

M.

Sig

Apply as directed.

In the treatment of diarrhea of typhoid fever: