EPSOM SALTS � MAGNESIUM SULPHATE
Compiled and Edited by Ivor Hughes

  United States Dispensatory 21st Edition 1926.
Martindales 24th Edition 1958
Boericke�s Homeopathic Materia Medica.

USD 21st 1926
MAGNESII SULPHAS.  U. S. , Br. MAGNESIUM SULPHATE Mag. Sulph.  [Epsom Salt]

" Magnesium Sulphate contains not less than 48.60 per cent, and not more than 53.45 per cent, of MgSO₄, corresponding to not less than 99.5 per cent, of the crystallized salt [MgSO₄.,7H₂O]." U.S. " Magnesium Sulphate may be obtained by the interaction of the native magnesium carbonates and diluted sulphuric acid; or by purifying the native sulphate. It contains not less than 97.4 per cent, of pure magnesium sulphate, MgSO₄,7H₂0." Br.

Sal Amarum, Sal Epsomense, Sal Anglicum, Sal Sedlicense, Sulphas Magnesicus; Sulphate of Magnesia; Sulfate de Magnesie, Fr. Cod.; Sel d'Epsom, Sel de Sedlitz, Sol. amer, Fr.; Magnesium Sulfuricum, P. G.; Magnesiumsulfat, Schwefeleaures Magnesia, Bittersalz, G.; Solfato di magnesio, Suifato magnesico, Sp.

Magnesium Sulphate is a constituent of sea water, and of some saline springs. It also occurs native, either crystallized in slender, prismatic, adhering crystals, or as an efflorescence on certain rocks and soils which contain magnesia and a sulphate or sulphide. In the United States it is found in the great caves so numerous to the west of the Allegheny Mountains . In one of these caves, near Corydon in Indiana , it formed a stratum on the bottom several inches deep, or appeared in masses sometimes weighing ten pounds, or disseminated in the earth of the cavern, one bushel of which yielded from four to twenty-five pounds of the sulphate. It also appeared on the walls of the cavern, and, if it was removed, acicular crystals again appeared in a few weeks. ( Cleveland .) An enormous deposit has been reported at Basque, British Columbia .

Under the name of kieserite, a mineral is obtained from the saline deposits at Stassfurt, in Germany , which consists chiefly of impure magnesium sulphate. It is used as a source for preparing magnesium sulphate, and is exported from Germany ; for a historical paper on Epsom salt by M. I. Wilbert, see Proc. A. Ph. A., 1904, 351.

Magnesium sulphate was originally procured by evaporating the waters of saline springs at Epsom, in England . Grew prepared it in this manner in 1675. It was afterwards discovered that the brine remaining after the crystallization of common salt from sea water furnished by careful evaporation precisely the same salt, and, as this was a much cheaper product, it superseded the former for a time. At present, in the neighborhood of Genoa and Nice, magnesium sulphate is prepared in large quantities from a schistose rock containing magnesia and iron sulphide. The mineral is roasted, and exposed in heaps for some months to the action of air and water. It is then lixiviated, the ferrous sulphate decomposed by lime water, and the salt obtained pure by repeated solution and crystallization. It is also extensively manufactured in Baltimore and Philadelphia from a siliceous magnesium hydroxide. This mineral occurs in veins in the serpentine and other magnesian rocks which abound in the neighborhood of Baltimore and in the southern counties of Pennsylvania . The mineral is reduced to a fine powder and saturated with sulphuric acid. The mass is then dried and calcined at a red heat, in order to convert any ferrous sulphate which may be present into ferric oxide. It is then dissolved in water, and calcium sulphide added to separate any remaining portion of iron. The salt is crystallized and dissolved a third time, in order to purify it. The sulphate prepared by this process is generally very pure and clean, although it sometimes contains a trace of ferrous sulphate. A very pure magnesium sulphate free from chloride is obtained as a by-product in the manufacture of carbon dioxide from magnesite when sulphuric acid is used to decompose the carbonate. This industry at one time assumed large proportions because of the demand for liquefied carbon dioxide in the manufacture of aerated and effervescing mineral waters. In the modern method of making carbon dioxide, however, acid is not used, the CO₂ being evolved by simply heating the magnesite (magnesium carbonate) to a little over 300� C. Magnesium sulphate is also obtained from kieserite and kainite from the Stassfurt mines, Germany . There are deposits of native magnesium sulphate, epsomite, in Wyoming , Utah , Washington and California . Dolomite (a native magnesio-calcium carbonate) is also used for the manufacture of magnesium sulphate, calcium sulphate being obtained as a by-product.

Description and Physical Properties. � "Small, colorless, prismatic needles or rhombic prisms, without odor, and having a cooling, saline, and bitter taste. One Gm. of Magnesium Sulphate is soluble in 1.3 cc. of water and in about 1.1 cc. of glycerin, at 25� C. One Gm. is soluble in about 0.2 cc. of boiling water. It is sparingly soluble in alcohol at 25� C. When exposed to warm air, the salt loses some of its water of crystallization and is converted into a white powder. Further heating removes more water, and at a temperature somewhat above 200� C. it is rendered anhydrous.

"An aqueous solution of the salt (1 in 20) responds to the reactions for magnesium and for sulphates. An aqueous solution of the salt (1 in 20) is neutral to litmus paper. " One Gm. of the salt shows no more chloride than corresponds to 0.2 cc. of fiftieth-normal hydrochloric acid. An aqueous solution of the salt meets the requirements of the test for heavy metals. An aqueous solution of the salt meets the requirements of the test for arsenic. " Preserve in well-closed containers."    U. S.

" In small, colorless, transparent, rhombic prisms. Taste bitter. Soluble in 1 part of water. Yields the reactions characteristic of magnesium and of sulphates. When 0.5 gramme is dissolved in 50 millilitres of water, and to the solution 20 millilitres of solution of ammonium chloride, 20 millilitres of strong solution of ammonia, and excess of solution of sodium phosphate are added in succession, the mixture, after well stirring and setting aside for twelve hours, yields a precipitate which, when collected, washed with strong solution of ammonia diluted with three times its volume of water, dried and heated to redness, weighs not less than 0.220 and not more than 0.226 gramme. Yields no characteristic reactions for zinc, and not more than the slightest reactions for chlorides. Lead limit 5 parts per million. Arsenic limit 5 parts per million. 10 grammes dissolved in 20 millilitres of water, and heated on a water-bath for one hour in a closed flask, yield a clear, colorless solution (absence of insoluble impurities and of more than traces of iron)." Br.

Assay. �" Dissolve about 1 Gm. of Magnesium Sulphate, accurately weighed in 100 cc. of distilled water, gradually add to the solution, with constant stirring, an excess of sodium phosphate T.S. (about 20 cc.), allow the mixture to stand for ten minutes, then add 30 cc. of ammonia T.S., and let stand for four hours. Collect the precipitate on a filter, wash it with dilute ammonia T.S. (1 volume of ammonia T.S. to 19 volumes of distilled water) until the washings are free from sulphates. Dry, and ignite to constant weight. The weight of magnesium pyrophosphate (Mg₂P₂O₇) when multiplied by 1.081 indicates its equivalent in MgSO₄. Each Gm. of Magnesium Sulphate corresponds to not less than 0.4495 Gm. and not more than 0.4944 Gm. of magnesium pyrophosphate (Mg₂P₂0₇)." U. S.

It usually occurs in small acicular crystals, which are produced by agitating the solution while crystallizing. It slowly effloresces in the air. Exsiccated magnesium sulphate is employed in some localities under the title Magnesium Sulphuricum Siccum. It is a fine white powder of which about 65 parts represents 100 parts of the crystallized salt.

Magnesium sulphate is completely decomposed by potassium and sodium hydroxides and their carbonates, by lime, barium and strontium oxides, and their soluble salts. Ammonia partially decomposes it, and forms with the remainder a double sulphate. Potassium and sodium bicarbonates do not decompose it, except by the aid of heat. An economic use which has been recommended of magnesium sulphate is the addition of a strong solution to ordinary white-wash, whereby a beautiful whiteness may be given to walls and ceilings. A little of it, moreover, added to starch considerably increases its stiffening properties, and at the same time in some degree resists the action of fire.

Uses. � Magnesium sulphate is an active cathartic operating with but little pain or nausea, and producing watery stools. Its cathartic action is due in part to its attraction for water, but it seems also to exercise a direct stimulant effect upon the glands of the intestinal tract. It has but little direct effect upon peristalsis, the increased movements of the intestinal muscles being due chiefly to the over distention with the fluid. It may be used whenever it is desired to clean out the alimentary canal, especially when a prompt action is desired, as in cases of poisoning or certain types of acute enteritis. It is a valuable remedy when it is desired to encourage the elimination of metabolic poisons through the bowel, as in gout or uremia. It is also highly esteemed for the evacuation of dropsical effusions. As an habitual laxative, although widely used, it is generally inferior to the vegetable cathartics.

When injected into the circulation magnesium sulphate acts as a violent poison, lessening respiration and depressing the circulation by a direct action upon the heart. It also paralyzes the peripheral ends of the motor nerves and, according to Meltzer and Auer (A. J. Phys., 1905, xiv, p. 366, and xvii, p. 313), also the sensory nerves. Guthrie and Eyan (A. J. Phys., 1910, xxiv, p. 329) dispute the conclusions of Meltzer and Auer that it has a true anesthetic action, believing that the apparent anesthesia is due to the motor paralysis, but the experiments of Wiki (A. I. P. T., 1911, xxi, p. 415) seem to demonstrate that when applied locally it is a paralyzant to the sensory nerves. -As an internal remedy it has been employed by intraspinal injection as an anesthetic and in the treatment of tetanus. Its action in tetanus appears to be solely that of an antieonvulsant, not a true curative, and whether it has any superiority over other methods of controlling the convulsions is at present uncertain. As an antitetanic fifteen to thirty grains (1-2 Gm.) may be injected daily into the subarachnoid space in 10 per cent, solution. For intraspinal anesthesia, although it has been used with apparent success in a few cases, it appears to have no advantage over the cocaine series and has shown itself distinctly irritant to the kidney.

As a local remedy magnesium sulphate has proven useful in a large number of inflammatory conditions, its value probably to be attributed to its osmotic influence. Because of the fact that it does not diffuse readily, it attracts more �water to itself than other salts. Not only is it

widely employed as a local dressing in sprains and bruises, but Tucker (T. G., 1907) and a number of subsequent investigators as Freese (N. T. M. J., Feb. 14, 1914) have reported favorable results in erysipelas, cellulitis, epi-didymitis, lymphangitis and similar external inflammations. Meltzer (J. P. Ex. T., 1918, xii), from experiments upon rabbits as well as in observations on human beings, found a 25 per cent, solution to be of great value in the treatment of burns of both first and second degree. Morrison and Tulloch (Brit. Journ. Surgery, Oct., 1915, p. 276) have even recommended the local use of a sterilized solution of magnesium sulphate in septic wounds.

Following the suggestion of Meltzer that the intra-duodenal application of magnesium sulphate produced a relaxation of the sphincter of the common bile duct, Lyon (/. A. M. A., 1919, Ixxii, p. 980) applied the drug by means of a duodenal tube in the diagnosis and treatment of cholecystitis. While the method has been more or less favorably commented on by several writers, Frazer (/. A. M. A., 1922, Ixxix, p. 1594) in experiments upon dogs was unable to note any constant action upon the flow of bile either from the liver or gall bladder. As Christison reported the case of a boy ten years old who was said to have been killed by two ounces of the salt without the induction of purgation, it is possible that, under some circumstances, when very large amounts of magnesium sulphate are given by the mouth, sufficient may be absorbed to produce poisonous effects.

Dose, one to eight drachms (3.9 - 31 Gm.).

Off. Prep. � Infusum Sennae Compositum, U. S.; Magnesii Sulphas Effervescens, N. F., Br.; Mistura Sennee Composita, Br.; Liquor Magnesii Sulphatis Effervescens, NF.; Sal Kissingense Factitium Effervescens, N. F.; Sal Viohyanum Factitium, N. F.; Sal Vichyanum Factitium Effervescens, N. F.

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Martindales 24th Edition 1958 (Br)
Magnesium Sulphate (B.P.). 
Mag. Sulph.; Epsom Salts; Sel Anglais; Sel de Sedlitz. MgSO_4,7H₂O = 246-5.
Dose: 2 to 16 g. (30 to 240 grains).
Foreign Pharmacopeias: In all pharmacopoeias examined.

Colourless odourless efflorescent crystals with a cool saline bitter taste. A solution in water is neutral to litmus.
Soluble 1 in 1-5 of water and 1 in less than 0-2 of boiling water; sparingly soluble in alcohol. Slowly soluble 1 in 1.5 of glycerin; for extemporaneous preparation dissolve 70 g. in 15 ml. of boiling water and add glycerin to 120 ml. Solutions are sterilised by autoclaving or by filtration. Incompatible with sodium and potassium tartrates, with soluble phosphates and arsenates, and with alkali carbonates and bicarbonates unless in dilute solution; with potassium or ammonium bromide concentrated solutions give a precipitate of the double sulphate. Protect from air and moisture in a cool place.

Toxic Effects. The magnesium ion is toxic when high concentrations accumulate in the extra cellular fluid. Although magnesium is poorly absorbed following oral administration, if given to a patient with impaired renal function there may be sufficient accumulation to cause poisoning. The use of magnesium sulphate by injection as a central and neuromuscular depressant may give rise to respiratory failure.

Death may occur within 2 hours of oral or rectal administration of magnesium sulphate in children with intestinal worms, or in other patients whose gut has become unusually permeable to magnesium sulphate. Extreme thirst and a feeling of heat are signs of poisoning. 1 g. of calcium gluconate should be injected intravenously as soon as possible.�D. W. Fawcett and J. P. Gens, /. Amer. med. Ass., 1943, 123, 1028.
Antidotes. Calcium gluconate or chloride should be given intravenously.

Contra-indications. Its use is inadvisable in the presence of renal disease and in children with intestinal parasitic diseases.
Uses. Magnesium sulphate administered in dilute solution is a prompt and efficient evacuant, producing watery stools with little or no griping. The injection, directly into the duodenum by means of a duodenal tube, of an ounce of a 25% solution causes relaxation of the sphincter of the gallbladder and permits the collection of the bile for study, or, when this does not appear, indicates obstruction of the gut (Meltzer-Lyon Test); this procedure has also been used for gall-bladder evacuation in cholecystitis.

Because of its osmotic and anaesthetic action it is widely employed for wet dressings, a 25 % solution being used in various inflammatory conditions such as sprains, bruises, orchitis, cellulitis, insect bites, epididymitis and erysipelas; it is employed as a paste in carbuncles and boils.
When introduced into the circulation, magnesium sulphate acts as a depressant to the central nervous system, and intravenous or intramuscular injections of 10 to 25 ml. of a 10% solution have been used to control eclamptic convulsions.
Cholesal (Oppenheimer). Granules containing magnesium sulphate and peptone. For hepatic and biliary congestion. Dose: 1 to 3 teaspoonfuls dissolved in not more than half a tumberful of hot water, at least '/a hour before breakfast.

Exsiccated Magnesium Sulphate (B.P.). Mag. Sulph. Exsic.; Dried Epsom Salts.
Dose: 2 to 12 g. (30 to 180 grains).
Foreign Pharmacopoeias: In Belg., Chin., Cz., Dan., Ger., Hung., Ind,, Jug., Nor., Pol., Swed., and Swiss.
A white odourless powder with a bitter saline taste, containing 62 to 70% of MgSO₄. Soluble 1 in 2 of water; more rapidly soluble in hot water. Protect from moisture.
Uses. Exsiccated magnesium sulphate is used in the preparation of powders and granules, and of Paste of Magnesium Sulphate.

Balneum Magnesii Sulphatis (B.P.C. 1949). 
Magnesium Sulphate Bath. Magnesium sulphate 1 lb. in 30 gal. of water.

Eau Saline Purgative (Fr. P.). 
Magnesium sulphate 35 g., sodium sulphate 35 g., water to 1000 g.

Enema of Magnesium Sulphate (B.P.C.). 
Enem. Mag. Sulph. (B.N.F.). Magnesium sulphate 50% w/v in warm water. 
Dose: 60 to 180 ml. (2 to 6 fl. oz.).

Gran. Mag. Sulph. Efferv. (B.P.C. 1949). 
Effervescent Granules of Magnesium Sulphate. Prepared from exsiccated magnesium sulphate 38.5 g., citric acid 12.5 g., tartaric acid 19 g., sodium bicarbonate 36 g., sucrose 10.5 g. A more palatable form of magnesium sulphate. Protect from moisture. 
Dose. For single administration, 15 to 30 g. (� to 1 oz.); for repeated administration, 4 to 12 g. (60 to 180 grains).

Magnesium Sulphate Injection (U.S.N.F.). 
A sterile solution in Water for Injection, usually available in various strengths from 5 to 50% w/v. Dan. P. includes a 20% w/v and Chil. P. a 25% w/v injection.

Mist. Chandos (Charing Cross Hosp.). 
Magnesium sulphate 120 gr., tincture of ginger 10 m., chloroform water to 1 fl. oz. �  Pharm. J. ii/1948, 126.

Mist. Mag. Sulph. Alb. pro Infant. (N.W.F. 1947). 
Mist. Alb. pro Infant. Magnesium sulphate 10 gr., light magnesium carbonate 1 gr., syrup 10 m., peppermint water to 60 m. 
Dose: 60 minims.

Mixture of Magnesium Sulphate (B.P.C.).  Mist. Mag. Sulph. (B.N.F.); 
White Mixture; White Mixture of Magnesium Sulphate; Mist. Alb.; Mist. Mag. Sulph. Alb. Magnesium sulphate 60 gr., light magnesium carbonate 10 gr., peppermint water to � oz
Dose: 15 to 30 ml. (� to 1 fl. oz.).

DISGUISING THE TASTE. The following are suggested for disguising the taste of mixture of magnesium sulphate: emulsion of peppermint (to intensify the peppermint flavour of the mixture), syrup, liquorice, fruit syrups, and syrup of ginger. Alternatively the mixture may be iced or magnesium sulphate may be given in the form of effervescent granules or with soda water.�Brit. med. J., ii/1956, 668.

Paste of Magnesium Sulphate (B.P.C.). Past. Mag. Sulph. (B.N.F.); 
Morison's Paste. Exsiccated magnesium sulphate, heated at 120� for one hour and cooled, 45 g., glycerin, heated at 120� for one hour and cooled, 55 g., and phenol 500 mg. Store in well-closed containers which prevent access of moisture, or in collapsible tubes.

This paste was originally advocated for the treatment of wounds, later for boils and carbuncles. It is applied to the boil or carbuncle and covered with lint or gauze and a waterproof material. The dressing is renewed at intervals until a slough has separated.
Morison's original paste was prepared by mixing l� lb. of exsiccated magnesium sulphate with 11 oz. of a 10% w/w solution of phenol in glycerin. The phenol was at first included for its analgesic properties, but its inclusion was later found to be unnecessary.�A. E. Morison, Brit. med. J., i/1918, 342.

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Boericke�s Homeopathic Materia Medica.
MAGNESIA SULPHURICA (Epsom Salt)

The skin, urinary, and female symptoms are most marked. The purgative action of Sulphate of Magnesia is not a quality of the drug, but a quality of its physical state, which renders its absorption impossible. The properties inherent in the substance itself can only be discovered by attenuation. (Percy Wilde.)

Head.�Apprehensive; vertigo; head heavy during menses. Eyes burn, noises in ears.

Stomach.�Frequent eructations, tasting like bad eggs. Rising of water in mouth.

Urinary.�Stitches and burning the orifice of the urethra after urinating. Stream intermits and dribbles. The urine passed in the morning copious, bright yellow, soon becomes turbid, and deposits a copious red sediment. The urine is greenish as -passed; is of a clear color, and in a large quantity. Diabetes. [Phos. oc.: Loct. ac.; Ars. brom.]

Female.�Thick leucorrhoea, as profuse as the menses, with weary pain in the small of the back and thighs, on moving about. Some blood from the vagina between the menses. Menstruation returned after fourteen days; the discharge was thick, black, and profuse. Menses too early, intermit.

Neck and Back.�Bruised and ulcerative pain between the shoulders, with a feeling as of a lump as large as the fist, on which account she could not lie upon her back or side; relieved by rubbing. Violent pain in the email of the back, as if bruised, and as before menstruation.

Extremities.�The left arm and foot fall asleep in bed, in the morning after waking.

Skin.�Small pimples over the whole body, that itch violently. Suppressed itch. [Sulph.] Crawling in the tips of the fingers of the left hand; better on rubbing. Wmts. Eyrsipelaa (applied locally as a saturated solution). Dropsy (physiological doses).

Fever.�Chill from 9 to 10 a. m. Shuddering in back; heat in one part and chill in another.

Relationship.�It is claimed that the addition of a small amount of Magnes. Sulph. to the usual hypodermic of Morphine increases the value of the hypodermic from 50 to 100%.

Physiologic Dosage.�Magnes. Sulph. is of diagnostic and therapeutic value in Gallstone colic. From 2 to 4 teaspoonful  in glass hot water taken at onset of a colicky attack may abort or stop the colic.

Epsom salt is one of the most active saline cathartics, operating with little pain or nausea, especially if pure. It has but little if any effect on intestinal peristalsis, its action causing a rush of fluid into the intestine, which by producing a distention of the bowel produces evacuation. It causes little or no irritation in the intestine. In common with the other salines, it is the classical evacuant to be employed in connection with mercurials and anthelmintics and in cases of poisoning. Epsom salt usually acts within from one to two hours, more quickly if taken in hot water and in the morning before breakfast. The ordinary dose as a mild laxative is a heaping teaspoonful; as a cathartic, two to four teaspoonfuls. The taste may be improved, if necessary, by the addition of a little lemon juice and sugar.

Besides its chief use as a saline cathartic, magnesium sulphate is used to a considerable extent externally in saturated solution as an antiphlogistic and antipruritic in erysipelas, ivy poisoning, cellulitis and other local inflammations. Use on compresses saturated with solution.

Dose.�The pure salt to the third potency. Locally 1:4 in water in septic conditions, erysipelas, orchitis, boils, etc.

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