Part 22

Christison, R. Treatise on Poisons. Edinburgh, 1845, p. 579.--Crampe. Bewährte Mittel gegen Feldmäuse. Deutsch. Landw. Presse, vol. 5, p. 530. 1878.--Felletar, E. Fälle von Intox. mit kohlensäur. Baryum. Pest. Med.-Chir. Presse, vol. 28, p. 1072. 1892.

Husemann, T. Ein Beitrag z. Kennt. d. Barytvergiftungen. Zeits. f. pract. Heilk., vol. 3, p. 235. 1866. In this article Husemann has collected many cases of poisoning by barium in animals.

Christison, R. Treatise on Poisons. Edinburgh, 1845, p. 579.

=BARIUM POISONING IN MAN.=

The high toxicity of barium was called attention to by early observers, but it was attributed by some to admixed arsenic. The reports of feeding experiments with barium on animals have varied markedly, but now care is being advised in the use of barium salts.

Barium was introduced into medicine in the treatment of scrofula, but has fallen into disuse, and only recently attention has been called to it on account of its action on the circulatory system. Filippi, however, says, "The effects on the heart and on the pressure are already the first indication of poisoning." This metal has also been used in the treatment of chronic diseases of the spinal cord, as multiple sclerosis and paralysis agitans.

After the administration to a woman of 1/12 grain (0.005 gram) of barium chlorid three to five times a day for a few days, a total of 2-1/4 grains (0.135 gram), the patient developed rapid respiration, tenderness over the epigastrium, nausea, constipation, cramps in the limbs, loss of appetite, weakness, great emaciation, dysuria, some deafness with tinnitus, difficulty in speaking and thinking, with vertigo. In this case the eyes were glassy, the vision indistinct, and the cheeks flushed. Kohl after the use of small doses of the same noted salivation, swelling of the gums, and falling out of the teeth, with a mercurial odor to the breath. Christison states: "I have known violent vomiting, gripes, and diarrhea produced in like manner by a quantity not exceeding the usual medicinal doses." According to Kennedy few persons are able to bear 1/8 grain (0.0075 gram) of barium chlorid.

In Carpenter's case after three doses of 1.6 grains (0.070 gram) of barium chlorid the patient developed almost lethal symptoms. Carpenter calls attention to the drowsiness which developed in this patient after the administration of barium, a fact which had already been noted by Christison.

A cartarrhal affection of various mucous membranes and a swelling of various glands have been noted, especially of the lymph and salivary glands, and in the male the testes have at times swollen. The inflammation of the glands may pass on to suppuration. The skin becomes dry and shows a tendency to crack. Febrile attacks are reported after the repeated use of small doses of barium.

Scheibler has called attention to the possibility of producing chronic barium poisoning in man from the use of barium in the manufacture of food products.

Acute cases of poisoning in man from four or more grams of barium carbonate or chlorid or nitrate have been reported more or less frequently. In the acute case of poisoning in man reported by Tiraboschi and Taito, no macroscopic changes were noted in the stomach mucosa. Lopes has reported one case of acute poisoning in man from less than 1 gram of barium chlorid. In this case paralysis of the limbs was a marked feature. Stern cites Perondi and Lisfranc to the effect that "remarkably large doses of barium chlorid can be borne without injury by gradually increasing the doses (dissolved in much water)." Lisfranc has suggested that the sensitiveness to poisoning by barium salts is greater in certain climates than in others.

No data are as yet available as to the influence of altitude and partial starvation on the toxicity of barium salts. As is well known, almost all recorded cases of locoed animals have occurred at a high altitude.

It must also be remembered that the addition of one salt to the solution of another may greatly increase the toxicity of the first one. Thus, the addition of a few milligrams of barium chlorid to a solution of a sulphocyanate renders the latter much more poisonous. This may be due to the fact that the salts are more completely ionized.

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FOOTNOTES:

According to v. Jaksch, "Sie ist bei der grossen Toxicität der Substanz immer ernst zu stellen." Vergiftungen, 1897, p. 79.

NOTE.--A thorough pharmacological study of some barium salt is much needed, and it is hoped that the writer will be able to complete this work.

Filippi, E. Modificaz. del Ricambio Organice per Azione del Cloruro di Bario. La Sperimentale, vol. 60, p. 610. 1906; Sull' Azione Cardiaca del Chloruro di Bario. Archivio di Farmacol. Speriment., vol. 5, p. 122. 1906.

Schulz, H. Vorles. ü. Wirkung. u. Anwendung d. unorganisch. Arzneistoffe. Leipzig, 1907, p. 234.--Hare, H. A. Use of Barium Chloride in Heart Disease. Med. News, vol. 54, p. 183. 1889.

Ferguson, J. C. Symptoms of Poisoning from Muriate of Barytes. Dublin Quart. Journ. Med. Sci., vol. 1, p. 271. 1846.

Christison, R., l. c., p. 580.

Kennedy, H. Dose of the Muriate of Barytes. Lancet, vol. 2, p. 28. 1873.

Carpenter, J. S. Barium Choride from a Clinical Standpoint. Med. News, vol. 59, p. 93. 1891.

Christison, R., l. c., 1845, p. 578.

Schulz, H. Vorles. ü. Wirkung. u. Anwendung d. unorganisch. Arzneistoffe. Leipzig, 1907, p. 233.--Schwilgué, C. J. A. Traité de Mat. Méd., 3 ed., vol. 1, p. 441. 1818.

NOTE.--According to the files of the Office of Poisonous-Plant Investigations, E. D. Smith reported in the Orange Judd Farmer, 1897, that locoed animals showed a swelling of various glands. As yet the writer has been unable to verify this reference.

Scheibler, C. Ueber d. Verwendung giftiger Stoffe, besonders d. Barytverbindungen bei d. Zuckerfabrication. Chem. Zeit., vol. 11, p. 1463. 1887.

Schmidt's Jahrbücher, vol. 192, p. 131. 1881.--Walsh, J. Report of a Case of Poisoning by Chloride of Barium. Lancet, vol. 1, p. 211. 1859.--Walch. Seltener Fall einer tödlich. Vergiftung d. Baryta muriatica. Zeits. f. Staatsarznk., vol. 30, p. 1. 1835.--Carpenter, J. S. Barium Chloride from a Clinical Standpoint. Med. News, vol. 59, p. 93. 1891.--Eschricht. Dødeligt forløbende Forgiftning med salpetersurt Baryt. Ugeskrift for Laeger, vol. 4, p. 241. 1881.--Ogler and Socquet. Empoisonnement par le Chlorure de Baryum. Annal. d'Hyg. Publ., 3 s., vol. 25, p. 447. 1891.--Chevallier, A. Note sur un Cas d'Empoisonnement Déterminé par l'Acétate de Baryte. Annal. d'Hyg. Publ., 2 s., vol. 39, p. 395. 1873.--Courtin, Cas d'Empoisonnement par du Chlorure de Baryum. Rev. d'Hyg., vol. 4, p. 653. 1882.--Poisoning by a Baryta Compound. Pharm. Journ., 3 s., vol. 2, p. 1021. 1872.--Reichardt, E. Vergiftungsfall mit kohlensäurem Baryt. Arch. d. Pharm., 3 s., vol. 4, p. 426. 1874.--Lagarde, P. Acétate de Baryte livré sous le Nom de Sulfovinate de Soude. Union Méd., 3 s., vol. 14, p. 537. 1872.--Baum. Zwei Fälle von fahrlässiger Tödtung durch saltpetersäures Baryt. Zeits. f. Medizinalbeamte, vol. 9, p. 759. 1896.--Funaro, A. Sul Veneficio per Sali di Bario. L'Orosi, vol. 12, p. 397. 1894.