Showing posts with label goiter. Show all posts
Showing posts with label goiter. Show all posts
Monday, January 16, 2012
Poetic license, perhaps...
"Tumidum Guttur" in Switzerland 164 Years Ago.
—To physicians traveling in Switzerland, a letter written by the poet, Thomas Gray (1716-1771) will prove of interest. Oliver Goldsmith, the thriftless, erratic, ill-disciplined Roscommon youth, and patientless graduate in medicine of the Dublin University, took at an early period of his career a prolonged flute-playing tour around and through the greater part of Western Europe. Like a true-born Hibernian genius, he was penniless, ragged, and partially—or wholly—barefoot throughout the prolonged period of his pilgrimage. But he saw what was worth observing, and he described some of the items as nobody else could. One of his published comments refers to the epidemic prevalence of thyroid tumors and cretinism in some of the Alpine valleys. Indeed, in certain Swiss districts when a young woman approached the marriageable age she was obliged—in the rare cases in which Nature's usual process had failed to supply her with the recognized proportion of thyroid development—to wear a false goiter in order to give herself a chance of the usual settlement in life.
source: American Medicine, Volume 6, 1903
~ since it was common for goiters to appear at puberty, a goiter could certainly signify sexual maturation...
Thursday, January 12, 2012
Iodine Deficiency in the Alps, 1800s
Source: The National Magazine, Vol XI, 1857
"Recollections of Switzerland"
 |
| Valais |
The dale of Valais opens before you, traversed by the Rhone on its way to the lake, the same as in the morning you had at your right that pleasant valley whence flows the Arve, coming from Chamouni, and commanded by bold Mont Blanc in the distance.
But while this opens widely, the valley of the Rhone, more inclosed by high mountains, presents, in spite of its rich vegetation, more somber perspectives, and has a mournful aspect. The snows do not shine so radiantly as those of Mont Blanc, which appear like a glittering carpet spread out for angels to climb upon to the furthest verge of earth, and rise from thence to heaven. Here they are scattering and hung upon the broken edges of cloud-capped summits, or else they appear in the distant horizon to form mysterious and inaccessible retreats.
If the shades of evening have commenced falling in the valleys, a secret terror glides into the imagination of the unaccustomed traveler at this threshold of unknown solitudes, leading to the summit of the Alps, to regions ever vexed with tempests, to a world which is always being menaced with glaciers and avalanches.
Unfortunate race! It would seem that Divine vengeance was wreaking itself on them, that they are the cursed offspring of some one of the Titans, who tried to scale heaven by piling up mountains, and were discomfited by the thunders of Jupiter.
On the contrary, however, the fathers of these poor idiots were a simple people and pious Christians, who came to find pasturage for their herds in these secluded valleys, who passed their lives in prayer, and through lack of bread lived upon milk; who, through lack of wine, cooled their thirst with the clear water of the rivulets. But this water, against which no instinct could guard them, tends to produce that most terrible of all maladies, the goiter, which becomes hereditary and acquires the fullest development; and under the influence of the same regime continued, the intellectual faculties
are changed, and idiocy appears. What venomous principle diffused in these running waters has led to such rapid and profound disorders in the physical organization, and consequently in the mind? None at all.
The presence of a little magnesia or the absence of a little iodine suffices to produce this effect. And this frightful degeneracy of the human species from the same causes manifests itself throughout mountainous countries, in the Pyrenees and in the Alps, in the Hartz and in the Jura, in the valleys of Thibet, in the Ural chain, in the Andes, and the Cordilleras.
The canton of Valais, in Switzerland, is one of those countries where there is a predilection to the goiter and idiocy. The latter, in its excess, is happily the exception, but the goiter, more or less developed, is general among the women, and it is almost as much of a deformity as the neck of a swan would be in carrying the head of a Valaisian woman.
Next to the goiter the most general characteristic of the Valaisian women is their singular hat. It is worn by the poor as well as the rich, only that of the rich is ornamented with a crest of a rich, wide, gold-colored ribbon, and the brim of it is formed by a multitude of black ribbons placed side by side upon the edge; a superfluity of ornament, the idea of which would scarcely enter the head of a Parisian milliner. These fine Valaisian hats are quite expensive; but one of them lasts a long time, for they are only worn on Sundays and occasional fete days.
If you scale the Alps, whose glaciers separate Switzerland from the kingdom of Sardinia, you will also find, in the southern valley of Aosta, the goiter and idiocy as much as in the northern valley already described. At the village of Aosta these things are infinitely worse. On a summer Sunday, if you pass through the streets at an hour when the inhabitants come and seat themselves before the door to enjoy the air, you will be much affected at the sight of the numerous idiots.
A single road easily accessible, the route so celebrated under the name of the Great St. Bernard, is the means of communication between these two valleys, so rich in beautiful and picturesque scenes, and so mournful by the degradation of a part of the human race.
Source: The National Magazine, Vol XI, 1857
Next to the goiter the most general characteristic of the Valaisian women is their singular hat. It is worn by the poor as well as the rich, only that of the rich is ornamented with a crest of a rich, wide, gold-colored ribbon, and the brim of it is formed by a multitude of black ribbons placed side by side upon the edge; a superfluity of ornament, the idea of which would scarcely enter the head of a Parisian milliner. These fine Valaisian hats are quite expensive; but one of them lasts a long time, for they are only worn on Sundays and occasional fete days.
If you scale the Alps, whose glaciers separate Switzerland from the kingdom of Sardinia, you will also find, in the southern valley of Aosta, the goiter and idiocy as much as in the northern valley already described. At the village of Aosta these things are infinitely worse. On a summer Sunday, if you pass through the streets at an hour when the inhabitants come and seat themselves before the door to enjoy the air, you will be much affected at the sight of the numerous idiots.
A single road easily accessible, the route so celebrated under the name of the Great St. Bernard, is the means of communication between these two valleys, so rich in beautiful and picturesque scenes, and so mournful by the degradation of a part of the human race.
Source: The National Magazine, Vol XI, 1857
Tuesday, January 10, 2012
pre iodine~ Spongia Usta
from "A treatise on Apis (the bee), Tella Araneae (cobweb),Spongia and Cantharis" by John Uri Lloyd, 1911~ A discussion on medicines of animal origin...
~spongia usta(burnt sponge) fell out of favor when it was perceived that the active ingredient was iodine and iodine alone.
from below: Spongia gives better results than iodine, in the more chronic forms of goiter.
"The sponges were formerly regarded by many naturalists as belonging to the vegetable kingdom. They are now regarded as compound animals by all, and by many as being even higher than the Protozoa, having close analogies with the Radiates."—Elements of Zoology, Sanborn.
Both sponge and its ash have been valued in medicine from a very early date, as shown by the following excerpt from Dioscorides. Translated and condensed by Miss Margaret Stewart, A. M.
"Fresh sponges, and those most free from oils, are helpful for wounds, and to check tumors. With water or vinegar, they bind up (literally, glue together) fresh wounds, while, cooked with honey, they join together old wounds. Old sponges are useless. But even these are of value in softening up callouses and separating ulcers that are growing together, if bound upon them, dry, with a linen cloth. Fresh sponges placed upon old ulcers full of corruption dry them up. They also check the flow of blood.
"Burned with vinegar, they are useful in inflammation of the eye; also where there is need of a detergent or astringent. But it is better to tincture the ashes with the remedies to be used for the eye. The ashes of sponges burned with pitch check the flowing of blood."—Dioscorides, V: 138.
History. Spongia Usta (Burnt Sponge).—This preparation, known in Dioscorides' day, and in subsequent medical works and Dispensatories as Spongia Usta, was once included among the most important of remedial agents. Not only did it occupy a prominent position in the works on domestic medicine, but in authoritative professional publications generally.
The third edition of the London Pharmacopeia, 1751, gives explicit directions for its preparation as follows:
Heat the sponge in a covered vessel, till it becomes black, and is easily friable; then reduce it to powder in a glass or marble mortar.
Remark.—The heat here used must be much greater than in the former process; but, however, care should be taken not to burn the sponge till its volatile salt be expelled, for so doing would reduce it to a mere coal; but the volatile salt is so much extricated from the other principles by this operation, that if it be rubbed to powder in a brass or bell-metal mortar, it is very apt to acquire from the vessel a taint, that will offend the stomach. —From Dispensatory of the Royal College of Physicians, London, 1751 (3d edition).
This substance crept as a matter of reference into many modern works, but its general use was abandoned very soon after the discovery of iodine and the compounds of iodine.
It will be noticed in the above formula that the sponge, after being burned, is to be powdered in a mortar of stone or glass, to protect against taint. This feature is more fully explained in Lewis' Materia Medica, London, 1768, wherein the foregoing formula, in substance, is given as follows:
"Burnt in a close, earthen vessel, till it becomes black and friable, it has been given in doses of a scruple against scrophulous complaints and cutaneous defedations; in which it has sometimes been of service, in virtue, probably, of its saline matter, the proportion of which, after the great reduction which the other matter of the sponge has suffered in the burning, is very large. By virtue of this saline matter also, the preparation, if ground in a brass mortar, corrodes so much of the metal, as to contract a disagreeable taint, and sometimes an emetic quality: hence the college expressly orders it to be powdered in a mortar of glass or marble".—Lewis's Materia Medica. London, 1768.
It is evident, as experience thus taught, that an emetic compound of copper was produced when a brass mortar was employed.
Coeval with such authorities, as well as others preceding and following, Burnt Sponge maintained its position as a remedial agent. Of this, a quotation from Motherby, giving the uses of Burnt Sponge, together with directions for preparing the drug, is sufficient as an illustration:
"Spongia is used in scrofulous disorders, and cutaneous foulnesses, for which end it is reduced, by lightly burning it, to a black powder, which is given in doses from gr. x to xx, two or three times a day; its virtues, which render it useful in these disorders, depend on a volatile, animal, alkaline salt (with which it abounds), and the oil of the sponge united.
When sponge is cut in small pieces, and freed from the stony matters which are lodged in it, it is burnt in a close, earthen vessel until it is black and friable, and when being powdered in a stone or a glass mortar, it is kept in a close vial for use. The burning should be discontinued as soon as the matter becomes thoroughly black; as the outside of a large quantity will be sufficiently burnt before the middle is much affected; the best method is, to cut it in small pieces, and keep it continually stirring in such a machine as coffee is roasted in."—Motherby's Medical Dictionary, London, 1755. (Second Edition.)
In 1812, M. Courtois, of Paris, in manufacturing soda, observed that the mother liquors from kelp corroded the boilers. In experimenting therewith he discovered the element, iodine. Close following came the fact that sea plants generally, as well as some of the lower forms of animal life of the sea, contained more or less iodine. The new element not only became a fashionable remedy for "scrophulous diseases," but led to the supposition that, as before stated, it alone constituted the remedial portion of Burnt Sponge. Thus, such authorities as Christison, in his Dispensatory, 1848, asserts:
Sponge contains a trace of combined iodine, and before the discovery of this element and its compounds, was, in the charred state, a remedy in scrofula and goitre. Its use internally, however, is now obsolete.
Indeed, it may perhaps be accepted that the discovery of iodine, and its occurrence in sponge, led the professions of medicine and pharmacy, theoretically, to displace Burnt Sponge with iodine and its compounds. For example, the Dictionary of Domestic Medicine, by Thompson and Smith, 1868, assumes as follows:
"Burnt sponge was formerly considered the best remedy in cases of "bronchocele."(aka goiter) It is now known that its power of removing that disease depended on the presence of iodine.
Notwithstanding this and other positive assertions concerning the iodine phase of the subject, Burnt Sponge continued, as a therapeutic substance, to occupy authoritative position. For example, the Pharmacopeia of the United States, 1830 edition, gave it a position, but not thereafter. The first edition of the United States Dispensatory, 1833, commented on it as follows:
The sponge is decomposed, the volatile matters being driven off by the heat, and a black, friable coal remaining, which consists of charcoal mixed with phosphate and carbonate of lime, chloride of sodium, carbonate of soda, and iodine in the state of hydriodate of soda. As the remedial value of burnt sponge depends chiefly upon the presence of iodine, it can not be esteemed good unless it afford purple fumes when acted on by sulphuric acid, assisted by heat. It is said that the preparation is most efficient as a remedy when the sponge is kept on the fire no longer than is necessary to render it friable. The powder is then of a much lighter color. Burnt sponge has been highly commended in goitre, glandular swellings of a scrofulous character, and obstinate cutaneous eruptions. It is most conveniently administered mixed with syrup or honey, in the form of an electuary, with the addition of some aromatic, as powdered cinnamon. The dose is from one to three drachms.—United States Dispensatory, Wood and Roche, 1833.
The first edition of the Eclectic Dispensatory, King and Xewton, 1851, gives the current uses of Burnt Sponge and its compounds, but neglects its assay constituents. In the second edition, 1854, the analysis is added, as follows:
"In 1,000 parts of sponge, 343.848 were dissipated by calcination: the remainder consisted of 327.0 parts of carbon and insoluble matters, 112.08 of chloride of sodium, 16.43 of sulphate of lime, 21.422 of iodide of sodium, 7.57 of bromide of magnesium, 103.2 of carbonate of lime, 35.0 of phosphate of lime, 4.73 of magnesia, and 28.72 of oxide of iron. The efficacy of burnt sponge depends principally upon the presence of iodine, and it should always be used when of recent calcination, as it becomes impaired rapidly in consequence of the volatilization of the iodine."—-King's American Eclectic Dispensatory, 1854.
While Professor King thus accepts the prevailing opinion that Burnt Sponge depends upon iodine and its compounds for its virtues, he wisely qualifies the assertion by stating that it depends "principally" upon the presence of iodine, in which direction Professor Wood, in his Dispensatory of the United States, above alluded to, 1833, states that the remedial value is due to the presence of iodine, and likewise qualifies his statement by the word chiefly.
Owing to the intrusion into therapy of iodine, and to its conspicuity, the natural compound known as Burnt Sponge largely disappeared from professional use, excepting in the Homeopathic and Eclectic practice of medicine, where iodine and iodine compounds have ever been viewed as things in themselves, Burnt Sponge being considered as a compound in itself. For example, Allen's Inscripta of Pure Materia Medica, Vol. 9, devotes eleven or more pages to its therapeutic use, whilst other Homeopathic pharmacopeias, such as that of the American Institute of Homeopathy, 1879, and tne United States Homeopathic Pharmacopeia, 1878, devoted due attention to the preparation of the drug, as well as its dilutions and triturations.
In this connection, it is evident in that in former times more or less questionings arose concerning the possibility of displacing Burnt Sponge by mixtures of charcoal and alkaline substances then known to be present in it. That these attempts thus to brush the remedy of old out of existence were failures is shown by a statement of the Royal College of Physicians, London, 1809, only two years before the discovery of iodine.
"Burnt sponge appears practically to produce effects which no mixture of the alkali and charcoal does, especially in the removal of bronchocele; and it is therefore retained."
Constituents.—Burnt Sponge contains a large amount of combined iodine, not "a trace" as Christison states. One minim of the Specific Medicine represents one grain of sponge, and (see Characteristics, p. 43) a fragment of a minim will give a deep blue color with starch paste. In addition bromine, phosphorus, sulphur, and other elements in unknown combinations go to make up Burnt Sponge. Whoever reasons concerning the action of compounds made up of such substances as unknown combinations of the elements that theoretically may be formulated into chloride of sodium, calcium sulphate, sodium iodide, magnesium bromide, calcium carbonate, calcium phosphate, magnesium and iron oxides, unknown sulphides, and phosphates reorganized from organic tissue and reconstructed by heat from complex organic bodies, presumes much in asserting that such combinations depend solely for their qualities upon a single substance that may by destructive chemical processes be isolated from the original product. The intermolecular constitution of Burnt Sponge is to-day unknown, and the part iodine takes in the therapy of that substance is also unknown.
Let us repeat that in our opinion the balanced structure, a complexity in itself, that results in the empirical production of the compound known as Burnt Sponge, can not be molecularly established by any theoretical computation made from a review of the isolated constituents thereof. Consequently, the uses of this preparation by physicians who employ it in contra-distinction to iodine or its compounds, are accepted as logically applying to a structural something, molecularly unknown, that must be very different from iodine, or a single iodine compound.
Pharmaceutical Preparations.—The uses of Burnt Sponge are recorded in the foregoing extracts, as well as in a multitude of like publications. The use in Eclectic medicine has been centered mainly on the alcoholic solution known as "Specific Medicine Spongia," in which one pound of Mediterranean natural sponge is burnt according to the old Pharmacopeial directions, and this triturated with alcohol while still hot. The mixture is allowed then to digest until all soluble material is extracted, when it is filtered. This preparation varies somewhat in composition, owing to differences in the sponge, but in general qualities it acts uniformly, as a whole.
Sponges are possessed of some form of mineral skeleton, calcareous, siliceous, and horny. They also enclose foreign substances which aid in giving them stability. These latter substances may be largely separated, mechanically, and magnesium and calcium salts may be dissolved by dilute acids. For the making of pharmaceutical preparations, the natural Mediterranean sponge, only, by this writer, is employed, never sponge that has been acid-cleaned, or chlorine-bleached. Scrap sponge (soft trimmings) is also very inferior, yielding little ash, and that of a poor quality. The whole sponge, carrying the base attachment should be employed, the ash of several bales of such sponges running from 30 to 36 per cent.
Such a natural (Mediterranean) Spongia Usta may be described as follows:
Spongia Usta varies, not only by reason of the sponge constituents, but through process influences. If the sponge be burned by allowing air to enter the vessel and thus produce a flame, or if the temperature be at first very hot and the process soon ended at a high heat, so as to dissipate all possible volatile constituents, the product is inferior. The combustion process must be a slow, smothering manipulation, in which, by a gradually raised heat in a vessel provided with a smoke exit, the product comes mainly to a gray-black or brown color. Throughout this charred, soft, pulverulent texture are to be found silvery specks of mineral matter, and even calcined shell, of considerable size. The odor of the ash reminds one of burnt coal of a marine nature. The taste is strongly saline, accompanied by a persistent, sulphide of hydrogen odor, and a sulphuret (sulphide) aftertaste. Treated with sulphuric acid in a covered beaker glass, effervescence follows, and violet fumes arise that change starch paper to a deep blue.
THE SPECIFIC MEDICINE SPONGIA.
Characteristics.—This preparation has a golden yellow color, and the odor of alcohol. Each minim represents one grain of sponge. The evaporation of 10 Cc. leaves about 0.58 per cent, of a crystalline residue, yellowish, and of a saline odor and taste. When in a beaker glass (covered by a watch crystal) sulphuric acid is poured over this residue effervescence follows, the mass assuming a violet color, by liberation of iodine, in places being very dark brown. The beaker becomes next filled with the characteristic violet iodine fumes which change starch paper to blue, or even to brown. On standing, the iodine fumes condense on the cover glass and the cooler parts of the beaker, as minute needle-like crystals. If the sulphuric acid treated mass be exhausted by 10 Cc. chloroform and filtered, a deep violet red solution results, which on spontaneous evaporation yields minute iodine crystals. If upon the contrary the residue be treated with alcohol, the solution is deep yellow, but carries the iodine. Both solutions turn starch paper dark blue, changing to brown. If a few drops of starch paste be spread over the bottom of a porcelain dish, one drop of a mixture of Sp. Med. Spongia and sulphuric acid in its center, will develop a blue color of varying degrees of intensity in accordance with the proportion of the ingredients.
Therapeutical Uses.—In consequence of its neglect by many teachers, as well as by reason of the quickly and yet illogically accepted premise (on the discovery of iodine) that one element, and one only, contributed to its efficacy, the use of spongia usta has been restricted mainly to the Homeopathic and Eclectic members of the American medical profession. These physicians also use iodine and its compounds when they are indicated, but they do not neglect "Spongia," as is shown by the confidence that experienced practitioners have in its clinical use, and that, too, a hundred years after the discovery of iodine. The Eclectic uses of Spongia, as given by Dr. George M. Hite, who uses the preparation extensively, are tersely expressed, as follows:
Uses.—"Spongia gives better results than iodine, in the more chronic forms of goiter. It is useful in chronic pharyngitis with thickening of the mucous membrane. In acute hoarseness from colds, it is the very best remedy of which I know, but it is chiefly as a croup remedy that I have used it. In follicular tonsillitis, Spongia is a most excellent remedy, and combined with other indicated remedies, as aconite, Phytolacca, and bichromate of potassium, will relieve in half the time the same prescription would, without the Spongia. It is a fine remedy in laryngitis, with burning, smarting, raw sensations, as it is also in tubercular laryngitis, relieving the teasing cough, and improving the health of the mucous membrane, overcoming the hoarseness, and improving the voice. I have used Spongia for many years, and always with specific results."
Indications.—Croup, with rough, barking, crowing, cough; stridulus respiratory sound during inspiration, with dry cough; loud wheezing respiration, with suffocative fits of coughing; inability to breathe except with the head thrown backward.
Dose.—1£ Sp. Med Spongia gtt. x to xxx.
M. Sig.—A teaspoonful every fifteen to thirty minutes, to one to two hours, as urgency of symptoms demands.—Geo. M, Hite, M. D.
~spongia usta(burnt sponge) fell out of favor when it was perceived that the active ingredient was iodine and iodine alone.
from below: Spongia gives better results than iodine, in the more chronic forms of goiter.
Spongia.
(SPONGIA USTA).
"The sponges were formerly regarded by many naturalists as belonging to the vegetable kingdom. They are now regarded as compound animals by all, and by many as being even higher than the Protozoa, having close analogies with the Radiates."—Elements of Zoology, Sanborn.
Both sponge and its ash have been valued in medicine from a very early date, as shown by the following excerpt from Dioscorides. Translated and condensed by Miss Margaret Stewart, A. M.
"Fresh sponges, and those most free from oils, are helpful for wounds, and to check tumors. With water or vinegar, they bind up (literally, glue together) fresh wounds, while, cooked with honey, they join together old wounds. Old sponges are useless. But even these are of value in softening up callouses and separating ulcers that are growing together, if bound upon them, dry, with a linen cloth. Fresh sponges placed upon old ulcers full of corruption dry them up. They also check the flow of blood.
"Burned with vinegar, they are useful in inflammation of the eye; also where there is need of a detergent or astringent. But it is better to tincture the ashes with the remedies to be used for the eye. The ashes of sponges burned with pitch check the flowing of blood."—Dioscorides, V: 138.
History. Spongia Usta (Burnt Sponge).—This preparation, known in Dioscorides' day, and in subsequent medical works and Dispensatories as Spongia Usta, was once included among the most important of remedial agents. Not only did it occupy a prominent position in the works on domestic medicine, but in authoritative professional publications generally.
The third edition of the London Pharmacopeia, 1751, gives explicit directions for its preparation as follows:
Heat the sponge in a covered vessel, till it becomes black, and is easily friable; then reduce it to powder in a glass or marble mortar.
Remark.—The heat here used must be much greater than in the former process; but, however, care should be taken not to burn the sponge till its volatile salt be expelled, for so doing would reduce it to a mere coal; but the volatile salt is so much extricated from the other principles by this operation, that if it be rubbed to powder in a brass or bell-metal mortar, it is very apt to acquire from the vessel a taint, that will offend the stomach. —From Dispensatory of the Royal College of Physicians, London, 1751 (3d edition).
This substance crept as a matter of reference into many modern works, but its general use was abandoned very soon after the discovery of iodine and the compounds of iodine.
It will be noticed in the above formula that the sponge, after being burned, is to be powdered in a mortar of stone or glass, to protect against taint. This feature is more fully explained in Lewis' Materia Medica, London, 1768, wherein the foregoing formula, in substance, is given as follows:
"Burnt in a close, earthen vessel, till it becomes black and friable, it has been given in doses of a scruple against scrophulous complaints and cutaneous defedations; in which it has sometimes been of service, in virtue, probably, of its saline matter, the proportion of which, after the great reduction which the other matter of the sponge has suffered in the burning, is very large. By virtue of this saline matter also, the preparation, if ground in a brass mortar, corrodes so much of the metal, as to contract a disagreeable taint, and sometimes an emetic quality: hence the college expressly orders it to be powdered in a mortar of glass or marble".—Lewis's Materia Medica. London, 1768.
It is evident, as experience thus taught, that an emetic compound of copper was produced when a brass mortar was employed.
Coeval with such authorities, as well as others preceding and following, Burnt Sponge maintained its position as a remedial agent. Of this, a quotation from Motherby, giving the uses of Burnt Sponge, together with directions for preparing the drug, is sufficient as an illustration:
"Spongia is used in scrofulous disorders, and cutaneous foulnesses, for which end it is reduced, by lightly burning it, to a black powder, which is given in doses from gr. x to xx, two or three times a day; its virtues, which render it useful in these disorders, depend on a volatile, animal, alkaline salt (with which it abounds), and the oil of the sponge united.
When sponge is cut in small pieces, and freed from the stony matters which are lodged in it, it is burnt in a close, earthen vessel until it is black and friable, and when being powdered in a stone or a glass mortar, it is kept in a close vial for use. The burning should be discontinued as soon as the matter becomes thoroughly black; as the outside of a large quantity will be sufficiently burnt before the middle is much affected; the best method is, to cut it in small pieces, and keep it continually stirring in such a machine as coffee is roasted in."—Motherby's Medical Dictionary, London, 1755. (Second Edition.)
In 1812, M. Courtois, of Paris, in manufacturing soda, observed that the mother liquors from kelp corroded the boilers. In experimenting therewith he discovered the element, iodine. Close following came the fact that sea plants generally, as well as some of the lower forms of animal life of the sea, contained more or less iodine. The new element not only became a fashionable remedy for "scrophulous diseases," but led to the supposition that, as before stated, it alone constituted the remedial portion of Burnt Sponge. Thus, such authorities as Christison, in his Dispensatory, 1848, asserts:
Sponge contains a trace of combined iodine, and before the discovery of this element and its compounds, was, in the charred state, a remedy in scrofula and goitre. Its use internally, however, is now obsolete.
Indeed, it may perhaps be accepted that the discovery of iodine, and its occurrence in sponge, led the professions of medicine and pharmacy, theoretically, to displace Burnt Sponge with iodine and its compounds. For example, the Dictionary of Domestic Medicine, by Thompson and Smith, 1868, assumes as follows:
"Burnt sponge was formerly considered the best remedy in cases of "bronchocele."(aka goiter) It is now known that its power of removing that disease depended on the presence of iodine.
Notwithstanding this and other positive assertions concerning the iodine phase of the subject, Burnt Sponge continued, as a therapeutic substance, to occupy authoritative position. For example, the Pharmacopeia of the United States, 1830 edition, gave it a position, but not thereafter. The first edition of the United States Dispensatory, 1833, commented on it as follows:
The sponge is decomposed, the volatile matters being driven off by the heat, and a black, friable coal remaining, which consists of charcoal mixed with phosphate and carbonate of lime, chloride of sodium, carbonate of soda, and iodine in the state of hydriodate of soda. As the remedial value of burnt sponge depends chiefly upon the presence of iodine, it can not be esteemed good unless it afford purple fumes when acted on by sulphuric acid, assisted by heat. It is said that the preparation is most efficient as a remedy when the sponge is kept on the fire no longer than is necessary to render it friable. The powder is then of a much lighter color. Burnt sponge has been highly commended in goitre, glandular swellings of a scrofulous character, and obstinate cutaneous eruptions. It is most conveniently administered mixed with syrup or honey, in the form of an electuary, with the addition of some aromatic, as powdered cinnamon. The dose is from one to three drachms.—United States Dispensatory, Wood and Roche, 1833.
The first edition of the Eclectic Dispensatory, King and Xewton, 1851, gives the current uses of Burnt Sponge and its compounds, but neglects its assay constituents. In the second edition, 1854, the analysis is added, as follows:
"In 1,000 parts of sponge, 343.848 were dissipated by calcination: the remainder consisted of 327.0 parts of carbon and insoluble matters, 112.08 of chloride of sodium, 16.43 of sulphate of lime, 21.422 of iodide of sodium, 7.57 of bromide of magnesium, 103.2 of carbonate of lime, 35.0 of phosphate of lime, 4.73 of magnesia, and 28.72 of oxide of iron. The efficacy of burnt sponge depends principally upon the presence of iodine, and it should always be used when of recent calcination, as it becomes impaired rapidly in consequence of the volatilization of the iodine."—-King's American Eclectic Dispensatory, 1854.
While Professor King thus accepts the prevailing opinion that Burnt Sponge depends upon iodine and its compounds for its virtues, he wisely qualifies the assertion by stating that it depends "principally" upon the presence of iodine, in which direction Professor Wood, in his Dispensatory of the United States, above alluded to, 1833, states that the remedial value is due to the presence of iodine, and likewise qualifies his statement by the word chiefly.
Owing to the intrusion into therapy of iodine, and to its conspicuity, the natural compound known as Burnt Sponge largely disappeared from professional use, excepting in the Homeopathic and Eclectic practice of medicine, where iodine and iodine compounds have ever been viewed as things in themselves, Burnt Sponge being considered as a compound in itself. For example, Allen's Inscripta of Pure Materia Medica, Vol. 9, devotes eleven or more pages to its therapeutic use, whilst other Homeopathic pharmacopeias, such as that of the American Institute of Homeopathy, 1879, and tne United States Homeopathic Pharmacopeia, 1878, devoted due attention to the preparation of the drug, as well as its dilutions and triturations.
In this connection, it is evident in that in former times more or less questionings arose concerning the possibility of displacing Burnt Sponge by mixtures of charcoal and alkaline substances then known to be present in it. That these attempts thus to brush the remedy of old out of existence were failures is shown by a statement of the Royal College of Physicians, London, 1809, only two years before the discovery of iodine.
"Burnt sponge appears practically to produce effects which no mixture of the alkali and charcoal does, especially in the removal of bronchocele; and it is therefore retained."
Constituents.—Burnt Sponge contains a large amount of combined iodine, not "a trace" as Christison states. One minim of the Specific Medicine represents one grain of sponge, and (see Characteristics, p. 43) a fragment of a minim will give a deep blue color with starch paste. In addition bromine, phosphorus, sulphur, and other elements in unknown combinations go to make up Burnt Sponge. Whoever reasons concerning the action of compounds made up of such substances as unknown combinations of the elements that theoretically may be formulated into chloride of sodium, calcium sulphate, sodium iodide, magnesium bromide, calcium carbonate, calcium phosphate, magnesium and iron oxides, unknown sulphides, and phosphates reorganized from organic tissue and reconstructed by heat from complex organic bodies, presumes much in asserting that such combinations depend solely for their qualities upon a single substance that may by destructive chemical processes be isolated from the original product. The intermolecular constitution of Burnt Sponge is to-day unknown, and the part iodine takes in the therapy of that substance is also unknown.
Let us repeat that in our opinion the balanced structure, a complexity in itself, that results in the empirical production of the compound known as Burnt Sponge, can not be molecularly established by any theoretical computation made from a review of the isolated constituents thereof. Consequently, the uses of this preparation by physicians who employ it in contra-distinction to iodine or its compounds, are accepted as logically applying to a structural something, molecularly unknown, that must be very different from iodine, or a single iodine compound.
Pharmaceutical Preparations.—The uses of Burnt Sponge are recorded in the foregoing extracts, as well as in a multitude of like publications. The use in Eclectic medicine has been centered mainly on the alcoholic solution known as "Specific Medicine Spongia," in which one pound of Mediterranean natural sponge is burnt according to the old Pharmacopeial directions, and this triturated with alcohol while still hot. The mixture is allowed then to digest until all soluble material is extracted, when it is filtered. This preparation varies somewhat in composition, owing to differences in the sponge, but in general qualities it acts uniformly, as a whole.
Sponges are possessed of some form of mineral skeleton, calcareous, siliceous, and horny. They also enclose foreign substances which aid in giving them stability. These latter substances may be largely separated, mechanically, and magnesium and calcium salts may be dissolved by dilute acids. For the making of pharmaceutical preparations, the natural Mediterranean sponge, only, by this writer, is employed, never sponge that has been acid-cleaned, or chlorine-bleached. Scrap sponge (soft trimmings) is also very inferior, yielding little ash, and that of a poor quality. The whole sponge, carrying the base attachment should be employed, the ash of several bales of such sponges running from 30 to 36 per cent.
Such a natural (Mediterranean) Spongia Usta may be described as follows:
Spongia Usta varies, not only by reason of the sponge constituents, but through process influences. If the sponge be burned by allowing air to enter the vessel and thus produce a flame, or if the temperature be at first very hot and the process soon ended at a high heat, so as to dissipate all possible volatile constituents, the product is inferior. The combustion process must be a slow, smothering manipulation, in which, by a gradually raised heat in a vessel provided with a smoke exit, the product comes mainly to a gray-black or brown color. Throughout this charred, soft, pulverulent texture are to be found silvery specks of mineral matter, and even calcined shell, of considerable size. The odor of the ash reminds one of burnt coal of a marine nature. The taste is strongly saline, accompanied by a persistent, sulphide of hydrogen odor, and a sulphuret (sulphide) aftertaste. Treated with sulphuric acid in a covered beaker glass, effervescence follows, and violet fumes arise that change starch paper to a deep blue.
THE SPECIFIC MEDICINE SPONGIA.
Characteristics.—This preparation has a golden yellow color, and the odor of alcohol. Each minim represents one grain of sponge. The evaporation of 10 Cc. leaves about 0.58 per cent, of a crystalline residue, yellowish, and of a saline odor and taste. When in a beaker glass (covered by a watch crystal) sulphuric acid is poured over this residue effervescence follows, the mass assuming a violet color, by liberation of iodine, in places being very dark brown. The beaker becomes next filled with the characteristic violet iodine fumes which change starch paper to blue, or even to brown. On standing, the iodine fumes condense on the cover glass and the cooler parts of the beaker, as minute needle-like crystals. If the sulphuric acid treated mass be exhausted by 10 Cc. chloroform and filtered, a deep violet red solution results, which on spontaneous evaporation yields minute iodine crystals. If upon the contrary the residue be treated with alcohol, the solution is deep yellow, but carries the iodine. Both solutions turn starch paper dark blue, changing to brown. If a few drops of starch paste be spread over the bottom of a porcelain dish, one drop of a mixture of Sp. Med. Spongia and sulphuric acid in its center, will develop a blue color of varying degrees of intensity in accordance with the proportion of the ingredients.
Therapeutical Uses.—In consequence of its neglect by many teachers, as well as by reason of the quickly and yet illogically accepted premise (on the discovery of iodine) that one element, and one only, contributed to its efficacy, the use of spongia usta has been restricted mainly to the Homeopathic and Eclectic members of the American medical profession. These physicians also use iodine and its compounds when they are indicated, but they do not neglect "Spongia," as is shown by the confidence that experienced practitioners have in its clinical use, and that, too, a hundred years after the discovery of iodine. The Eclectic uses of Spongia, as given by Dr. George M. Hite, who uses the preparation extensively, are tersely expressed, as follows:
Uses.—"Spongia gives better results than iodine, in the more chronic forms of goiter. It is useful in chronic pharyngitis with thickening of the mucous membrane. In acute hoarseness from colds, it is the very best remedy of which I know, but it is chiefly as a croup remedy that I have used it. In follicular tonsillitis, Spongia is a most excellent remedy, and combined with other indicated remedies, as aconite, Phytolacca, and bichromate of potassium, will relieve in half the time the same prescription would, without the Spongia. It is a fine remedy in laryngitis, with burning, smarting, raw sensations, as it is also in tubercular laryngitis, relieving the teasing cough, and improving the health of the mucous membrane, overcoming the hoarseness, and improving the voice. I have used Spongia for many years, and always with specific results."
Indications.—Croup, with rough, barking, crowing, cough; stridulus respiratory sound during inspiration, with dry cough; loud wheezing respiration, with suffocative fits of coughing; inability to breathe except with the head thrown backward.
Dose.—1£ Sp. Med Spongia gtt. x to xxx.
M. Sig.—A teaspoonful every fifteen to thirty minutes, to one to two hours, as urgency of symptoms demands.—Geo. M, Hite, M. D.
Monday, January 9, 2012
Pulsing the dose, eating dulse and seaweed poutices... 1827
from the Edinburgh Journal of Medical Science, Volume 2, 1827
We have again to record another case, published by Dr Reynaud, in the Journal Complementaire, relative to the administration of iodine, which certainly indicates, not only that its efficacy is far from being proportionate to the quantity in which it is given, but that its operation in reducing goitrous tumours is extremely gradual. Dr Reynaud's patient had been, during two months, put on a course of iodine, taking from ten to twenty-four drops of the tincture three times aday, without any change in the volume of the tumour having been manifested. He ceased, during six months, to make use of this medicine; and, during this interval of abstinence from it, the effect of the iodine manifested itself, and the goitre was reduced to half its size. A friction with the pomade of the hydriodale of potash was then ordered, and the cure was completed. It was hence inferred, that considerable advantage might be derived, in some cases, by allowing interruptions during the administration of iodine.
We consider the foregoing statement a most important illustration of the advantage of administering iodine in small doses, yet prolonged for a considerable time. Hence its efficacy when taken along with alimentary matters. We can, on this principle, account for the alleged virtues of the Spongia usta, in which so small a portion of iodine is contained. And, in like manner, probably may be explained a popular remedy which we remember to have seen practised in a county of the north of England. It was, to send patients afflicted with strumous complaints to the sea coast, there to remain for several months, and to undergo the daily external application of cataplasms, almost entirely composed of sea-ware, in which, as chemists well know, a notable quantity of iodine is contained. But, at the same time, the internal administration of some species of Fuci, probably that known in Scotland by the name of dulse, (Fucus palmatus), was likewise enforced. Mr Neill, in his "Tour through Orkney and Shetland," has furnished us with an anecdote illustrative of the ancient medicinal virtues which were ascribed to this plant. "There is a common saying in Stronsa, that he who eats of the dulse of Guiodin, and drinks of the wells of Kildingie, will escape all maladies except black death.'"
~ a "cataplasm" is a poultice. I assume that "sea-ware" is seaweed...
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