Balsams

BALSAAMS and balsamic preparations are diverse products of the chemical metamorphosis of plant cells, contained in the intercellular passages of the bark and wood of many plants and consisting of essential oils, resins, and mixtures of these with other organic substances, chiefly of a series of aromatic compounds. Among balsams, the following have therapeutic significance: turpentine (01. Terebinthinae), obtained from different species of the genus Pinus (family Coniferae); Copaiba (B. Copaivae) from tropical trees of the genus Copaifera (family Leguminosae, South America); Peru balsam (B. peruvianum) from Myroxylon Pereirae (family Leguminosae, Republic of San Salvador); Toluban balsam (B. tolu-tanum) from Toluifera balsamum (family Leguminosae, Central America); liquid styrax (Styrax liquidus depuratus) from Liquidam-bar orientalis (family Hamamelidaceae, Minor Asia). - Balsams are pungent, thick liquids of a bitter taste and acidic reaction, insoluble in water, but miscible with alcohol, ether, chloroform, and oils. The main constituent parts of balsams are essential oils and the product of their transformation—resins, which, by their chemical nature, belong to oxygen derivatives of mono- and polynuclear terpenes; balsams may also contain certain aromatic compounds in the form of complex esters, aldehydes, keto-novs, and others. Depending on the predominance of certain compounds in balsams, they may exert different pharmacological actions: antiseptic, local irritant, expectorant, diuretic, etc., although in most cases this action is not sharply expressed. In the body, balsams largely transform into compounds with glucuronic acid, the irritating action of which is weakened more than the antiseptic action compared to balsams, and only a smaller part of balsams is excreted unchanged. Of the listed balsams, turpentine is rarely applied as such, but mainly in the form of the essential oil obtained from it—turpentine oil. Copaiba balsam is used, chiefly, as a remedy against gonorrhea (see below). Peru balsam is applied against lice and, especially, against the scabies mite, since, killing it together with its eggs, it relatively little irritates the skin; as an antiseptic and weak local irritant it is used even in dressing wounds and ulcers whose healing proceeds sluggishly, but is applied with caution, since in the presence of a large wound or ulcer surface, Peru balsam may exert an irritating action on the kidneys and the urinary Bladder. Toluban balsam and the cheaper Styrax liquidus depuratus are used externally instead of Peru balsam, and the former of them also internally as an expectorant. - Balsams serve, as a constituent part, together with other substances—essential oils, extracts, tinctures, alcohols, etc., for the preparation of complex pharmaceutical preparations now bearing the name "balsamic preparations," to the number of which belong some liquid or semi-liquid medicinal mixtures not containing balsams but containing pungent active principles. Many of such mixtures have entered pharmaceutical practice and have become known among the population also under the name of balsams, for example: aromatic, Bengali (or Benge), Weimar, clove, infantile, gastric, vital, May, opodeldok, sedative, and others. In addition, to the number of balsamic preparations one must refer such liquid preparations as aromatic waters containing balsams, or mother's milk containing benzoic resin; sometimes balsamic preparations are also referred to pungent ointments containing substances close to balsams, for example, camphor, turpentine, turpentine, poplar, etc.

M. Likhachev. Balsams in the treatment of gonorrhea. Balsamic preparations used for the treatment of gonorrhea consist of various terpene derivatives, variously combined and standing in close genetic connection with each other: terpenes, terpene alcohols, resinous acids and esters. They have been famous from ancient times as remedies against gonorrhea and were considered at that time specific. Their action does not lend itself to a strict scientific explanation. A more plausible view is that urine containing volatile glucuronic acids—derivatives of ingested balsamic preparations—during its passage through the urinary tract acts astringently and antiseptically on the inflamed mucous membrane. Schmiedeberg indicates that, transforming into urine in the form of potassium or sodium compounds of resinous acids, balsamic preparations prevent the decomposition of drops of urine that have lingered in the urethra and thereby do not create for gonococci predisposing moments for their multiplication. Circulating in the blood, balsamic preparations activate individual cells of the organism, especially the epithelium of mucous membranes, in the struggle against the penetrated infection (Bogdanov). It is this increase in the local resistance of cells that explains the favorable influence of balsamic preparations on gonorrheal processes in organs not washed by urine (joints, tendon sheaths, etc.). According to the research of Vith and Ehrmann, balsams possess astringent, vasoconstricting and reducing secretion properties, act anesthetically on mucous membranes, and finally, irritating the renal epithelium, are a good diuretic. Balsams do not possess bactericidal properties in relation to the gonococcus. From this review of the pharmacodynamic properties of balsams follow indications for their appointment. In the acute stage of the disease, especially in the presence of frequent and painful urination and erections, bloody discharges, balsams may manifest their maximum action, since they weaken inflammatory phenomena. The application of balsams is also indicated in cases where gonorrheal urethritis proceeds under the guise of a severe infectious disease with a high t° and general decline of strength and when local treatment for some reason is contraindicated or impossible. With simultaneous application of balsams and local treatment, the gonorrheal process proceeds better; recovery occurs sooner than with local treatment alone. Balsams can also cause a number of unpleasant side effects: first, vasomotor disorders in the form of spotted or diffuse erythema, sometimes accompanied by itching; second, phenomena on the part of the kidneys of congestive character, characterized by pains in the lumbar region. However, albuminuria occurs quite rarely in this case. The protein test with HNO_s is deceptive in such cases due to the precipitation of white cotton-like sediment dissolving in large quantities of alcohol and ether. Finally, some patients complain of sharp pains in the abdomen and loss of appetite as a result of taking balsams internally. One should never prescribe balsams to patients suffering from albuminuria or digestive disorders. Having prescribed balsamic preparations, one must watch the urine so that in case of the appearance of formed elements or protein in it, their intake is stopped. Balsams have in most cases a repulsive taste and smell and cause unpleasant oily eructation. With the aim of correcting the taste, Posner proposed prescribing them together with peppermint oil. With the aim of reducing eructation, it is recommended to take balsams in gelatin capsules and after food. Of individual balsamic preparations it should be mentioned the above-mentioned Copaiba balsam, the oldest and cheapest, but most often giving complications, which, apparently, stand in direct dependence on the age of its preparation. Santal oil and its derivative santil are the least irritating to the intestine. Gonosan—a compound of kava-kava and santal oil—acts strongly anesthetizing.