ACTION OF PHOSPHORUS 181 



acid in the body. Its fate is unknown, but some phosphorus is eliminated 

 as vapor from the lungs and some in organic compounds in the urine. 



The toxic action of phosphorus differs decidedly from its therapeutic 

 effect and so does the action of pure phosphorus from its compounds. 

 The action of phosphates, phosphoric acid and hypophosphites is not at 

 all that of phosphorus. 



Most of the hypophosphites are eliminated unchanged in the urine 

 and do not act as phosphates, as formerly believed. They appear to 

 have little more influence than sodium chloride, except the iron salt, where 

 the metallic ion acts as other iron compounds. Phosphoric acid stimulates 

 digestion and secretin formation, like other mineral acids, but is inferior 

 in this respect to hydrochloric acid. It has been given internally for its 

 supposed action as a phosphate, but the organic phosphate compounds of 

 the body cannot be built from the inorganic salts. Lecithin owes its 

 value to its phosphorus content (4%). On the market it is a yellowish 

 white mass derived from yolk of eggs. It is essential in building the 

 nuclein content of cells and has been given in anemia. Ordinary food is 

 rich in lecithin, especially grains, eggs and milk, so that lecithin is com- 

 monly not indicated in disease when the diet is ample. 



Calcium hypophosphate, lactophosphate and glycerophosphate act 

 similarly to calcium phosphate (page 127). 



Toxicology. — The symptoms of poisoning do not ordinarily appear 

 until some hours after ingestion of toxic doses (15 to 20 grains of phos- 

 phorus poison horses; 1^ to 4 grains are toxic for dogs). Then abdomi- 

 nal pain, nausea and vomiting (in those animals in which it is possible) 

 and purging occur. The breath, vomitus and fecal discharges may be 

 luminous, and have the odor of phosphorus. There is fever, anorexia 

 and thirst. This condition is followed by an intermission in which the 

 patient appears to be recovering, only to be succeeded by jaundice, 

 hemorrhages (due to fatty degeneration of vessels and blood poor in 

 fibrinogen), nervous symptoms, as delirium, coma and convulsions, and 

 death. The urine rarely becomes albuminous in animals, but contains 

 leucin and tyrosin. The heart muscle is directly paralyzed by lethal 

 doses. 



Grave, destructive metabolic changes (autolysis) occur in the tissues 

 — especially the liver. There is general fatty degeneration of the viscera 

 and muscles. The blood is disorganized, and there are widespread 

 ecchymoses. Jaundice follows closure of the common, or hepatic duct, or 

 smaller biliary tubules (owing to proliferation of interstitial tissue, seen 

 also in the stomach and kidney), and disorganization of the blood. There 

 is rapid atrophy of the liver, and phosphorus poisoning in man is often 

 indistinguishable during life from acute yellow atrophy of the liver. 

 Nitrogenous elimination is increased. Imperfectly decomposed products 

 of metabolism, as leucin and tyrosin, occur in the urine; also an excess 

 of urea and ammonia and often blood, bile and fat and sarcolactic acid. 

 It is a matter of dispute whether the fat deposited in the cells of the 

 tissue is formed there (fatty degeneration), or is conveyed thence from 

 that alreaay existing in the subcutaneous tissue. Chronic poisoning, at- 

 tended with necrosis of the jaw and other symptoms, and occurring among 



Digitized by Microsoft® 



