Uranii Nitras.—Uranium Nitrate. Dose, gr. j to gr. v. It may be administered in pill form or in solution.

Actions and Uses

According to Dr. West, Leconte was the first to observe that uranium nitrate given to dogs caused glycosuria. In 1888 Chittenden, and in 1889 Chittenden and Lambert, published their observations on the physiological action and toxic effects of this substance. In 1891, Cartier in his Thése de Paris gave an elaborate account of the actions of the salts of uranium. Recently (1895) Dr. Samuel West, of St. Bartholomew's Hospital, London, has published a clinical study of the nitrate. There is unusual unanimity in the results of these studies. The various researches show that the salts of uranium are actively toxic. They cause, both in animals and in man, gastro-intestinal inflammation, a rapid decline in flesh and strength, and death by failure of respiration. Their poisonous effects are due to a destructive action on the epithelial structures of the body, on the arrest of the amylolytic and proteolytic processes whereby the ferment powers of pepsin and ptyalin' are destroyed, on the combination with albumin, arresting its transformation, on the liver and kidneys, with the production of albuminuria and diabetes, and in the final production of uraemia. When the nitrate of uranium is injected into the blood in small quantity it causes rise of temperature, and increases the excretion of carbonic acid. In small doses, in what manner soever administered, it acts on the renal epithelium, and albumin appears in the urine. In larger doses, an important result is the occurrence of diabetes. The urine is otherwise changed, the phosphates increased, the chlorides lessened, peptones, acetone, lactic and butyric acids appear (Cartier). The quantity of albumin appears to be considerable, chiefly according to the amount given, and we may therefore assume according to the extent of the changes in the renal epithelium. After the albuminuria has occurred for a variable period, the glycosuria comes on, and this-also has close relations with the amount taken. The uranium salts have not been detected in the urine, so that their effects must be exerted on the hepatic and pancreatic secretions, and the changes in the renal epithelium must be a part of a general process in which the albumin, or rather the protoplasm of the body, is rendered incapable of structural metamorphosis.

It is a peculiarity of uranium that small doses seem nearly, if not quite, as effectual as large ones. When its effects are produced and it is then discontinued, much larger doses than those originally administered are necessary to bring about the same results. Hence, it is suggested that uranium begets a certain tolerance by continued use.

Therapy

The therapeutical uses of uranium have been deduced from its physiological actions. It is said that Dr. Hughes, of London, a homoeopathic practitioner, was the first to make use of the nitrate as a remedy for diabetes. As, however, it acts by destroying the amyiolytic and proteolytic ferments, and in consequence the conversion of glycogen is prevented, the law of similars can hardly be invoked to explain such a result. The first scientific application of nitrate of uranium to the treatment of diabetes was made by Dr. West, of St. Bartholomew's Hospital, London. He reports a number of cases in which marked improvement took place. He began with one or two grains of the nitrate twice daily after the principal meals. It should be freely diluted with water. He increased the dose slowly, and in some cases the quantity rose to as much as fifteen grains, without producing any troubles of digestion, nor did its prolonged administration bring on albuminuria. It does not appear that in any case the sugar disappeared entirely from the urine, but it was usually greatly reduced in amount, and at the same time there ensued great improvement in the general state.

As uranium causes albuminuria as well as diabetes, it would seem that we have in these salts a remedy for that state also. The albumin is present, because of an acute parenchymatous nephritis which it induces. It is much to be desired that further careful studies be made on this point.

Uranium Oxalate.

Uranium and Barium Oxide (Barium Diuranate).

Uranium and Strontium Oxide (Strontium Diuranate).

These are combinations of therapeutical agents hitherto used only in the arts, notwithstanding the individual components of them have been employed successfully in the treatment of disease.

Uranium oxalate occurs as a yellow powder, and is an active irritant poison. The initial dose should not be greater than one sixth of a grain. As oxalic acid has been administered successfully in the treatment of amenorrhoea, and as it causes albumin to appear in the urine, and as uranium has similar actions, inducing glycosuria as well as albuminuria, the combination is indicated in these affections, and probably also in other maladies of the genito-urinary apparatus.

Uranium and barium oxide is an orange powder, and is an irritant poison. The dose of this should not be greater at the outset than one fourth of a grain. As barium has a selective action on the vascular system, and uranium on the kidneys, the combination is indicated in acute renal diseases with elevated temperature.

Uranium and strontium have similar properties. The initial dose may be one grain, and this may be increased as required.

Authorities referred to:

Cartier, Francois. Glycosuries toxiques et en particulier intoxication par le nitrate d'urane. Thése iv, 154 pp., Paris.

West, Dr. Samuel. The British Medical Journal, August 24, 1895.