HYDROGEN DIOXIDE. — Hydrogen dioxide, peroxide; peroxide of hydrogen; or oxygenated water in a pure, undiluted state, is a syrupy liquid of unstable com position. It readily decomposes into oxygen and water. It is rarely met with in its pure state.
For medicinal and surgical uses a di luted solution is official; it deteriorates by exposure to heat, sunlight, or longed shaking. It is, however, the most stable solution that has been prepared. Preparation and hydro genii dioxidi (3 per cent. or 10 vol., U.
S. P.), 30 to 120 minims.
Physiological Action. — The official solution has a slightly acid taste, owing to the presence of a small amount of acid added as a preservative. Taken into the mouth it foams and produces a slight pungent, stinging sensation. Its proper ties are those of an antiseptic, deodorant, and styptic. Its effects are produced by the liberation of oxygen and by conse quent oxidation. Taken internally, hy drogen dioxide is not poisonous.
The possibility suggested that the per oxide contains impurities of an irritating nature, these impurities being the salts and acids used in the production of the remedy in question, and which in them selves must be poisonous. Blackader (Boston Med. and Surg. Jour.. May 19, '92).
At ordinary temperatures and with ordinary agitation hydrogen dioxide is practically decomposed in eight weeks. Pressure exerts no restraining influence in this change. Boroglycerin, added in proportion of I per cent., retards decom position, but does not prevent it. Ex teniporaneous preparation of hydrogen dioxide as required is recommended. Squibb (Ephemeris, Jan., '94).
This apparently innocent substance is not always free from dangerous effects. The "explosive" manner to which the gas is sometimes given may distend and rupt ure tissues and carry infection into the cellular tissues for a considerable dis tance. Case of mammary carcinoma in which the injection of a small sinus with the peroxide of hydrogen resulted in opening up and carrying infection into the axi]la. G. W. Spencer (Then Gaz., July 15, '99).
Therapeutics.—Hydrogen is an active destroyer of false membranes, pus, and pathogenic germs. It is sometimes used as a diagnostic means for the detection of pus, since contact with pus causes a foaming and frothing until all traces of pus have disappeared. It is also used in dressing wounds, etc.
Puttmann and Liebreieh consider the internal use of peroxide of hydrogen dangerous and useless. For its use, in cases of hyperemesis gravidarum, good results have been claimed. Barons
claims that folded sheets steeped in peroxide of hydrogen and hung up iu the sick-room will cut short the course of whooping-cough. The author con that this simple remedy deserves a trial. Some of the ill effects of the drug are ascribed to the fact that the preparation usually sold is chemically impure, and not concentrated enough. Von Bruns has had a preparation made which is ten times as strong as the ordinary commercial preparation, and which is chemically pure. This prepara ion is said to have been used with very g, ml results in infected wounds. It is also used in ophthalmic practice, for corneal abscess with hypopyon, for iris and as a hmmostatic in cataract operations. It is further said to he of service in bad-smelling otitis media (otorrhcca) and purulent rhinitis, and in endometritis. For the last named, a wool packing, soaked in per oxide, is supposed to be able to take the place of curetting. Lewitt (Deutsche med. Wochen., May 16, 1901).
DIPIITHERIA.—Hydrogen dioxide is one of the most valuable applications for the destruction and removal of false membrane, and this without danger of poison or of irritation. On contact with the false membrane an active efferves cence ensues, and the membrane comes away in pieces or shreds. It is best ap plied in spray form, using a rubber or glass-tipped atomizer on account of the oxidizing influence upon metal spray tubes. It may also be applied by means of a swab or a glass syringe.
Hydrogen peroxide in a number of cases of diphtheria produced appearances which might have been mistaken for the original disease, but which readily dis appeared on withdrawing the peroxide. The disease hail not only not been bene fited, but had been prolonged by the use of the drug. Jacobi (Boston Med. and Surg. Jour., May 19, '9'4).
Fifteen-volume solution of peroxide of hydrogen used in the form of a spray in the mouth and nose in diphtheria with out any bad results. It seemed for a time to lessen the membrane, but the latter quickly returned. Buckingham (Boston Med. and Surg. Jour., May 19, '92).
Case in which, thirty-six hours after using the peroxide of hydrogen in weak solution as a spray and gargle, a whitish veil appeared in the mouth, and then beginning ulceration and a pseudomem brane over these ulcerated spots. The peroxide was stopped and the patient recovered. Caill6 (Boston Med. and Surg. Jour., May 19, '92).