Aurum

Gold

Gold. Or, Fr. ; Gold, Ger.

Auri et Sodii Chloridum

Gold and sodium chloride. A mixture of equal parts by weight of dry gold chloride and sodium chloride. An orange-yellow powder, odorless, having a saline and metallic taste, and very soluble in cold water. Dose, gr. 1/20—gr. 1/5. The chloride of gold is not official, and is not suitable for internal administration.

Antagonists and Incompatibles

Eggs, albumen, milk, flour, are chemical antidotes. The contents of the stomach should, of course, be evacuated. The principles of treatment are the same as for poisoning by corrosive sublimate.

Synergists

The salts of mercury, especially the corrosive chloride, are very similar in action to the chlorides of gold, and are therefore synergistic.

Physiological Action

The chloride of gold is a caustic in its local action. In toxic dose it excites violent gastro-enteritis, accompanied by such nervous phenomena as cramps, convulsive trembling, insomnia, priapism, insensibility, etc. In small medicinal doses these auric preparations promote the appetite and the digestive capacity. If long continued, especially if the dose be a full medicinal one, epigastric pain and distress are excited, nausea is induced, and loss of appetite follows. Constipation is usually produced by the preparations of gold, and this, notwithstanding an increased secretion of the intestinal glandular apparatus is one of the results of their administration. These preparations do not probably entirely enter the blood from the stomach, but part passes to the intestinal canal, is there decomposed, and is absorbed as oxide in combination with albumen. This is, however, conjectural. They are readily soluble and are very diffusible substances. What particular influence they exert on the composition and function of the blood is at present quite unknown. A form of fever, known as auric fever, is caused by their prolonged administration. This fever is accompanied by profuse sweats, a very abundant flow of urine, and increased salivary secretion. The salivation caused by the preparations of gold differs from the mercurial in that there is no tenderness nor ulceration of the gums.

Peculiar effects on the mental state are produced by the administration of the auric preparations. The functions of the mind become more active, and even excited, and a state of cheerfulness is induced. In men, marked aphrodisiac effects are produced, and the erections are often painful; in women, increased venereal desires and augmentation of the menstrual flow are observed.

The elimination of the auric preparations takes place by the liver, the intestinal canal, but chiefly by the kidneys. The urine assumes a bright-yellow color.

Prolonged administration of medicinal doses induces epigastric heat and oppression, headache, dryness of the throat and mouth, gastrointestinal irritation, fever.

Therapy

The chloride of gold and sodium, in small doses (1/20 grain) three times a day, will relieve nervous dyspepsia. A red and glazed tongue, epigastric pain, increased by taking food, and a tendency to relaxation of the bowels after eating, are indications for the use of this salt. Catarrh of the duodenum, catarrh of the bile-ducts, and jaundice dependent thereon, are symptoms which may usually be removed by the salts of gold if given in small doses.

Injections of gold and sodium chloride are strongly advocated by Drs. Shurley and Gibbes, of Michigan, in cases of pulmonary tuberculosis.

In certain convulsive neuroses of the respiratory organs, the chloride of gold and sodium has seemed to be very effective; for example in laryngismus stridulus, whooping-cough, etc.

Amenorrhoea, dependent on torpor of the ovaries, may be removed by the persistent use of auric preparations. Chronic metritis, with scanty menstruation, is often remarkably benefited by them. Sterility, dependent on these states, or due to coldness, is more certainly cured by these agents than by any other merely medicinal means. It is said by Martini that the tendency to habitual abortion may be averted by the use of chloride of gold.

Decline of the sexual power in man may be prevented by the use of gold salts, and the following are symptoms which may be removed sometimes by them: diurnal seminal losses, weak and inefficient erections, inability for the sexual congress, due to irritability of the sexual organs. They increase the frequency of the nocturnal losses in those who are suffering from plethora of these organs. Cases that are benefited by the bromide of potassium are increased by the chloride of gold, and vice versa.

The author calls especial attention to the use of the salts of gold in chronic Brigt's disease—granular and fibroid kidney. His experience, narrated in successive editions of this work, has continued to be highly favorable, and various confirmatory observations have been published by others. The double chloride—of gold and sodium—is the preparation to use, and the dose will vary from -1/10—120 grain.

The nature of the curative action consists in the impression made on the connective-tissue elements; it prevents or lessens the overgrowth, and hence it is now utilized in the treatment of the various scleroses—of the liver, of the kidney, of the arterial system (arteriosclerosis), and of the nervous system.

Excellent results are obtained from the use of the double chloride in certain forms of mental disorder: e. g., melancholia, hypochondria, and allied mental states, accompanied by depression. Vertigo and vertiginous sensations, when due to stomach-disorders, are often removed by minute doses, but plethora and increased intracranial blood-pressure contraindicate their use; on the other hand, they have a high degree of utility when there is present the condition of cerebral anaemia. The author has been favored with a private communication from Dr. Bauduy, of St. Louis, in which this experienced and able physician expresses his confidence in the value of this remedy in the treatment of hypochondriasis and melancholia. In Chaucer's "Canterbury Tales," which appeared near the close of the fourteenth century, we find the following couplet:

"For gold in physic is a cordial,

Therefore, he loved gold in especial." Also, in that curious mixture of scholastic learning and whimsical suggestion, the "Anatomy of Melancholy," gold is recommended as the best remedy for mental depression.

Authorities referred to:

Gubler, Dr. Adolph. Commentaires du Codex Medicamentarius, Paris, 1868, p. 506

Nothnagel, Dr. Hermann. Handbuch der Arzneimittellehre, Berlin, 1870, p. 310.

Martini, Dr. Ludwig. Schmidt's Jahrbücher der gesammten Medirin, etc, vol. cxlvi, p. 263.

Trousseau et Pidoux. Traité de Therapeutique et de Matiére Médicale, huitiéme édition, vol. i, p. 388.