Am.  Jour.  Pharm.  \ 
December,  1894.  J 
Notes  on  Lithium. 
589 
salts  as  an  internal  remedy,  both  in  cases  of  uric  acid  diathesis 
connected  with  gravel,  and  likewise  in  chronic  gout,  and  was  much 
gratified  at  the  results."  But  he  subsequently  adds,  "  the  great 
bar  to  the  free  use  of  lithium  salts  in  medicine  has  been  their 
expense."1 
The  price  of  the  remedy,  however,  does  not  seem  to  have  deterred 
Garrod  from  its  continued  use,  since  we  find  him,  in  the  treatise 
referred  to,  devoting  a  very  considerable  space  to  a  review  of  the 
important  therapeutic  results  personally  obtained  by  him  from  the 
use  of  the  salts  of  lithium,  and  their  undeniable  superiority  over 
any  other  alkaline  salts  whatever,  for  both  internal  and  external 
exhibition.  An  indorsement  so  unqualified,  coming  from  such  high 
authority,  as  a  matter  of  course,  at  once  attracted  the  attention  of 
the  medical  world  to  the  remedy,  and  gave  an  immense  impetus  to 
experimental  investigation  with  lithium  salts  in  therapeutics.  It  is 
seldom,  however,  that  the  individuality  of  an  investigator  or  observer 
is  sufficiently  pronounced  to  carry  universal  conviction  of  the  truth 
of  his  observations  or  conclusions,  especially  in  researches  of  this 
description;  and  here  we  find  the  medical  profession  at  once  divided 
as  to  the  correctness  and  value  of  Garrod's  conclusions.  A  contro- 
versy was  inaugurated,  on  both  sides  of  which  talent  and  learning 
were  enlisted,  and  which  has  brought  about  a  very  decided  advance 
in  knowledge  of  the  behavior  of  the  alkalies  in  general,  and  espe- 
cially towards  uric  acid.  We  need  not  dwell  on  the  merits  of  this 
discussion,  but  pa>s  to  more  modern  matters. 
The  behavior  of  lithium  carbonate  toward  uric  acid,  and  its  influ- 
ence upon  the  solubility  of  the  urates  in  the  human  economy,  have, 
in  many  instances,  without  doubt,  been  greatly  exaggerated,  a  fact 
due  mainly  to  the  lively  imagination  of  owners  of  certain  mineral 
springs,  who  herald  their  waters  not  merely  in  the  daily  press,  but 
in  medical  and  trade  journals,  through  advertisements,  in  which,  to 
quote  Dr.  A.  C.  Peale  :  "  The  fact  that  the  water  contains  lithia, 
if  only  a  trace,  is  made  prominent  by  the  incorporation  of  4  lithia  ' 
into  the  name  or  designation  of  the  spring." 
Louis  Siebold  rose  against  these  unwarrantable  exaggerations 
and  usurpations  in  a  paper  on  "  Medical  and  Chemical  Misconcep- 
tions about  Lithia,"  read  before  the  British  Pharmaceutical  Confer- 
1  Treatise  on  gout  and  rheumatic  gout,  by  Sir  A.  B.  Garrod  ;  first  edition, 
i860 ;  third  edition,  1877  ;  pp.  368-69. 
