It may also be used in hemorrhage from the mouth or throat, and to arrest bleeding from leech-bites. The latter is often extremely obstinate, and has even proved fatal. A method I have long used, with uniform success, is to make a saturated solution of alum in hot water, to impregnate a dossil of raw cotton with this before it begins to crystallize on cooling, and then to press the cotton upon the bite. In this way the salt is applied more effectually than it can be by any other method; as the saturated hot solution is vastly stronger than the cold, and still retains the alum, at a temperature at which it may be well tolerated by the skin. It is even better than the powder itself, which acts probably only so far as it is dissolved, and is less soluble in the blood than it is in hot water. The same application may be made, with prompt effect, in the bleeding from the socket of an extracted tooth, which it is sometimes very difficult to arrest In severe uterine hemorrhage, recourse may also be had to the strong solution of alum as a local styptic; the liquid being injected, or applied by means of a sponge saturated with it. and introduced into the vagina.

Morbid secretions may sometimes be advantageously treated by the topical use of alum. Thus, its solution has been employed in leucorrhoea, gonorrhoea and gleet, profuse salivation, colliquative sweating, to check excessive suppuration from ulcerated surfaces, and in cases of purulent ophthalmia*

As an injection into serous cysts, a solution of alum, containing four or five grains in the fluidounce, has been employed with the effect of produring a cure; but care is necessary thoroughly to evacuate the cyst afterwards, for fear of exciting inflammation.

* Dr. Pereira states that, "in the treatment of the purulent ophthalmia of infants, no remedy is perhaps equal to an alum wash;" and Dr. F. J. Farre. editor of the abridged edition of Pereira's Materia Medica (p. 103), adds that "the wash should contain eight grains of alum in an ounce of water, and should be introduced between the lids every quarter of an hour. Thus used," he says, "the wash seldom fails." (Note to the third edition).

To obviate relaxation of (issue, alum is locally used, commonly in solution, in flabby and fungous ulcers, and in prolapsus of the uvula, rectum, and uterus. It is employed also in aneurism from anastomosis, in order to produce contraction of the vessels. A cataplasm of alum-curd may sometimes be preferable, in the cases of ulcer and anastomotic aneurism. On the same principle of obviating relaxation, may be explained the asserted advantage of alum gargles in some cases of loss or alteration of voice. (Bennati, Bullet. Gen. de Therap., i. 256).

In the earliest stage of inflammation, before any other change has taken place than mere congestion of the vessels, alum applied to the part sometimes arrests the disease, by diminishing the caliber of the capillaries, and thus excluding an excess of blood. For this purpose, it is much used in mucous inflammation of the fauces, or ordinary angina. A gargle made of alum, sage tea, and honey has long been a popular remedy for sore-throat. The remedial impression, however, is due to the alum alone; the other ingredients simply serving to qualify the taste. Some persons are very liable to these anginose attacks, which not infrequently subject them to great inconvenience, and sometimes to danger, by extending to the larynx, bronchia, or even pulmonary tissue. The attack may often be warded off by proceeding immediately, upon the occurrence of the first symptoms, to gargle the throat with a strong solution of alum; taking at the same time a dose of sulphate of magnesia, and using an exclusively vegetable diet. But when the inflammation has become firmly established, the remedy will generally be useless or worse than useless, until the activity of the symptoms has subsided; when, if a relaxed state of the vessels remain, keeping up a slight chronic congestion, it may be again resorted to with advantage. The form of lozenge has been suggested by M. Argenti, of Venice, as sometimes preferable to gargles. Held in the mouth, and allowed slowly to dissolve, it is kept in constant contact with the diseased membrane, and may be supposed to act more effectually than when the medicine is intermittingly employed. The lozenge may be made by incorporating powdered alum, sugar, and trag-acanth, by means of some aromatic liquid.

In the pseudomembranous form of angina and stomatitis, such as attends diphtheria, and in the same condition occurring in scarlet fever, a strong solution of alum, or the salt in powder, is sometimes very effectual. The powder may be applied by means of the finger, or more conveniently by introducing it into a tube, and through this blowing it into the fauces. This application of alum in modern times we owe to Bretonneau. It is generally made in cases of infants, who are most subject to the diphtheritic affection. It is usually followed by a copious salivation, and by efforts to vomit; but these cease after a few minutes. The remedy is equally effectual when applied to the false membrane, which, during the prevalence of an epidemic of the disease, is apt to form on other part, as the nipple, mucous membrane of the generative organs, and ulcerated surfaces in any portion of the body. It may be used also in obstinate aphthous incrustations of the mouth. The alternate application of powdered alum and tannic acid, one or the other being used every hour, has also been recommended in pseudomembranous angina. (Ann. de Therap., 1859, p. 114).

Painful caries of the teeth may sometimes be relieved by filling the cavity with a paste made of alum, ether, and a little mucilage, which may be repeated twice a day while the pain lasts. ( Trousseau et Pidoux, 4e ed., i. 137).

In commencing ophthalmia, alum sometimes arrests the disease; but in this affection, the solution should be much weaker than when used for the throat, or to arrest hemorrhage. When the inflammation is fixed, the remedy is no longer applicable; but it sometimes comes again into play when, in the advanced stage, the eye remains red, and perhaps blood-shot, from a passive distension of the vessels. Another mode of using alum in ophthalmia is in the form of alum-curd, which may be applied as a poultice over the closed eyelids, between pieces of soft linen or gauze. Reference has already been made to its peculiar efficacy in the purulent ophthalmia of infants. (See page 140 and note).

Other forms of inflammation, in which alum-curd may be employed, are chilblain before the cuticle is broken, and the erythematous redness which results from pressure, as in the cases of patients long confined to bed with diseases of debility.

Administration

The dose of alum for ordinary purposes varies from five to fifteen grains, which in chronic cases may be given three or four times a day, and in those more acute, every two or three hours. It may be taken either in powder or solution. In either case, it will often be desirable to make some aromatic addition, to obviate nausea. Five grains of pulverized nutmeg are often added to each dose of the powder; and an equal weight of white sugar may be mixed with it, in order to qualify the taste.

Another form of administration is that of alum-whey. This is made by boiling two drachms of the powdered salt with a pint of milk, and straining after coagulation. The dose is from one to three tablespoonfuls.

For external use, the curd remaining after straining the milk, in the preparation of the whey, may be employed in the form of cataplasm. Another mode of making an alum cataplasm is to rub the white of egg with a piece of alum, in a saucer, until the albumen coagulates; or a drachm of powdered alum may be well shaken or beaten with the whites of two eggs. The curd thus prepared may be applied between folds of soft linen.

The solution of alum for external use is of various strengths, according to the purpose for which it is employed. In commencing ophthalmia its strength should not at first exceed four or five grains to a fluidounce of water; for application to the urethra from five to ten grains. A much stronger solution, containing fifteen or twenty grains in the fluidounce, has been above recommended for various purposes.

Alum is among the substances most used by means of the atomizer. Its solution, containing from ten to twenty grains to the fluidounce, is inhaled in the state of spray, in chronic bronchitis and laryngitis, especially when attended with excessive secretion; and, containing forty grains, has been found useful in pulmonary hemorrhage.

The uses of Dried Alum (Alumen Exsiccatum, U. S.) will be treated of under Escharotics.