ioo MATER i A ME DIG A AND THERAPEUTICS. 



1. IMMEDIATE LOCAL ACTION. 



Externally and internally phosphorus acts as a powerful 

 local irritant and caustic, and is never given to produce this 

 effect. For the same reason the drug must not be ordered 

 in the solid form, but carefully mixed with oil or fat. 



2. ACTION ON THE BLOOD AND ITS USES. 



Phosphorus enters the blood, and may be found in it un- 

 changed. Here it is partly oxydised into phosphorus or phos- 

 phoric acid at the expense of the oxygen of the red corpuscles, 

 and is therefore said to have a "reducing" action on the (oxy-) 

 haemoglobin or "blood." The small dose sufficient to cause 

 death will not reduce any considerable number of the corpuscles, 

 and the specific effects to be presently described cannot there- 

 fore be accounted for by interference with the oxygenating 

 function of the blood. 



Phosphorus has been employed in leukaemia and lymph- 

 adenoma, but on the whole with disappointing results. 



3. SPECIFIC ACTION AND USES. 



In the tissues phosphorus may be traced as the uncombined 

 element another proof that its oxydation in the blood is 

 incomplete. Its effect on metabolism, when given in large 

 doses, is most distinct and definite : it increases the nitrogenous 

 products, including urea, tyrosin, and leucin; reduces the 

 glycogen of the liver to nil; raises the temperature, diminishes 

 the excretion of carbonic acid, and the volume of oxygen ab- 

 sorbed ; and leads to fatty degeneration of epithelial, glandular, 

 and muscular protoplasm throughout the body. No doubt these 

 alterative effects are essentially associated with each other; 

 phosphorus, whilst increasing metabolism, so influencing it as to 

 diminish oxydation, and thus to arrest the process at the first 

 stage, where proteids are converted into urea and oil, instead of 

 allowing it to proceed to the second or final stage, where the 

 oil is further oxydised into carbonic acid and water. Hence all 

 the results just enumerated ; whilst the soluble products (urea, 

 etc.) are excreted, the insoluble products (oils or fats) are re- 

 tained in the tissues, constituting fatty degeneration. 



The uses to which phosphorus has been put as a specific 

 remedy do not obviously depend upon these effects upon nutri- 

 tion. It has been given in nervous disorders, such as neuralgia ; 

 in adynamic conditions, such as typhoid fever ; in some 

 kinds of skin diseases, including pemphigus ; and as an 

 aphrodisiac. It is difficult to understand how any of these 

 morbid states can be benefited by a substance which diminishes 



