Collargol

COLLARGOL, colloidal silver, Collar-golum, Argentum colloidale Crede (Ph. VII). Colloidal silver was introduced into therapy in 1896 by Crede. The most common method of obtaining C. consists in the reduction of solutions of metallic salts with a small amount of alkali and hydrazine in the presence of protein, gum arabic, etc., with removal of electrolytes by dialysis followed by evaporation of the solution. To purify colloids of all metals and obtain them in dry form, precipitation with alcohol from solution is used. The pharmaceutical preparation of colloidal silver—collargol—is obtained in the case where the colloidal silver precipitates from a solution containing protein, which here acts as a protective colloid; the latter contributes to the stability of the preparation. C. contains 67-70% silver and about 30% protein (Ph. VII-74.7% silver). C. appears as greenish or bluish-black flakes with a metallic luster when broken; it dissolves in water up to 5%, does not dissolve in ether, and is almost insoluble in alcohol (0.2%). The solution of C. in reflected light is dark greenish-brown in color, and in transmitted light it is reddish-brown. The solution of C. 1:500 is completely opaque, 1:2,000 is reddish-brown in color. In a place protected from light, aqueous solutions of C. do not decompose, remaining transparent and sterile. Solutions of C. withstand single boiling without change. Mineral acids precipitate C. from aqueous solutions, but upon neutralization C. again goes into solution. Upon dilution of the C. solution with water, a clear solution should be obtained; the appearance of cloudiness and precipitate indicates decomposition. Unlike silver oxide, solutions of C. do not have an alkaline reaction to litmus. When C. is burned, the smell of burnt hair is perceived. The particles of C. in solution, when measured with an ultramicroscope, have an average size of 30-20 μμ=0.00003-0.00002 mm; C. of Soviet production-40 μμ=0.00004 mm. Solutions of C. are very photosensitive. C. possesses bactericidal properties, and its inhibitory effect on the growth of microorganisms is particularly pronounced. A solution of C. 1:5,000, applied for several minutes, inhibits the growth of virulent staphylococci. C. does not irritate tissues and is not poisonous. Upon administration of C. into the body, a temporary decrease in the number of leukocytes in the blood is observed, followed by leukocytosis. Previous authors explained the action of C. by its antiseptic properties, which was enhanced in the presence of proteins; thus, Behring and Koch note that silver preparations in protein fluids have high bactericidal power, five times exceeding that of sublimate. C. has adsorptive properties with respect to toxins. The presence of a protective colloid—protein—in C. enhances the chemotherapeutic action of C., which thus acts in two ways: both as silver and as a protein preparation. Some authors explain the action of C. only by the latter. Local application of C. is due to its antiseptic action; in this case, C. does not cauterize mucous membranes and does not irritate them. C. is absorbed in small amounts in the digestive tract and can then, like other silver preparations, be deposited in the skin and various internal organs in the form of reduced silver or as its albuminate. A small amount of silver after absorption circulates in the body. Unabsorbed silver, given per os, is excreted with feces; absorbed silver is not excreted from the body. C. is used in aqueous solutions locally or internally, in the form of ointments, enemas and intravenously. Locally, C. serves as an antiseptic that does not irritate tissues; in solutions of 1:100-500—for washing purulent wounds, cavities of abscesses, etc. In urology, C. is used for irrigations in urethritis (1:400), for introduction into the posterior urethra according to Guyon (1:50), for irrigations of the bladder in bleeding and inflammation of it (1:1,000-2,000). In gynecology—in catarrh of the cervix and uterus (irrigate with a solution of C. 1:3,000-1,000). In ophthalmic practice—compresses (0.01-1% solution), eye drops (0.5-5%) in purulent diseases of the conjunctiva, blennorrhea; in these same cases, 1-2% eye ointment is used. Internally, C. is prescribed for gastrointestinal diseases (catarrh of the stomach, tuberculous diarrhea) and for disinfection of the urinary tract in the form of a 0.5-0.75% solution of C. three times a day, 1 teaspoonful for children and 1 tablespoonful for adults. In enemas, C. is indicated for disinfection of the large intestine and combating general infection of the body (see below) 2 times a day, 50 cm³ of a 1-2% solution of C. after preliminary washing of the intestine. C. is widely used for the treatment of infectious and septic diseases of a general nature: in erysipelas, septic endocarditis, joint rheumatism, complications of gonorrhea, postpartum septicemias, peritonitis, meningitis, abdominal and relapsing typhus, scarlet fever, severe forms of influenza. In assessing the effect of C. in the treatment of the above diseases, opinions are extremely contradictory. Most clinicians at the present time deny favorable results from treatment with C. For these diseases, C. is used either in enemas, as indicated, or intramuscularly and intravenously—5-10 cm³ of a 2% solution of C., freshly prepared; the infusion is done every other day until a persistent decrease in temperature and disappearance of other painful symptoms. Collargol ointment, named after its author Crede, contains 15% C. and is used for general infectious diseases in the form of rubbing into the degreased skin of the back 2-3 times a day, 3.0 per rubbing for an adult and 1.0-2.0 for children. C. is also used for prophylactic purposes in cavity operations and after operations that suggest the danger of subsequent infection (purulent wounds, etc.). Side effects of C.: with internal use—sometimes vomiting, diarrhea, and with prolonged use for months—argyria; with rectal administration—burning in the rectum, tenesmus; with intravenous use—trembling and chills, a brief rise in temperature, dizziness, nausea, cyanosis, arrhythmia, skin itching. With intravenous administration of long-standing and moreover unfiltered solutions, embolisms were observed, even with a fatal outcome. With intramuscular administration of C., painful infiltrates with tissue necrosis are often observed, for which reason intramuscular administration of C. has been abandoned. All these side effects require symptomatic treatment. Poisonings with C. are rarely observed; antidotes—as in poisoning with silver preparations, in addition—symptomatic measures. Other preparations of colloidal silver. 1. Electrargol, Electrargol, Electrocollargol, colloidal silver obtained electrolytically by spraying metallic silver between the poles of a Volta arc in water. The principle of action is the same as in C. The action of electrargol is stronger, since each particle of silver in electrargol is half the size of that in C. (equal to 10 μμ), and thus its surface of action is much larger. Electrargol is used in the same cases as other colloidal silver preparations. Preparations of electrargol: French electrargol; contains 0.025% silver, used intravenously and intramuscularly with isotonic NaCl solution; dose intravenously—5-10 cm³ every other day or daily; intramuscularly—10-15 cm³; into the spinal canal, 3-5 cm³ are injected after removing the same amount of cerebrospinal fluid; locally, electrargol is used in urology, ophthalmology, etc. German preparation—electrocollargol—contains 0.6% silver in solution; dose intravenously—2-10 cm³, gradually increasing; intramuscularly—0.5-5.0 cm³. Solutions of electrargol and electrocollargol for injection into a vein must be free from precipitate. The side effects of electrargol are the same as with C. 2. Dispargen, Dispargen, colloidal silver with 30% metal. Dispargen is used like C. in a 2% solution, 2-5 cm³ intravenously. 3. Agoleum, Agoleum, a preparation of colloidal silver in the form of a suspension in oil with 1% silver content. Agoleum is used for the treatment of catarrhs of the bladder in the form of instillation into the bladder 10 cm³. 4. Synthargol, Synthargol, consists of salts of bile acids and 10% colloidal silver. Synthargol is used for the treatment of urethritis and in ophthalmic practice. 5. Pyelon, Pyelon, colloidal iodine-silver; used as a contrast medium in X-ray examination of the bladder in a 5-7.5% solution, of the urethra and renal pelvis—in a 10-20% solution. 6. Jodcollargol, Jodcollargol, a colloidal preparation of iodine (31.7%) and silver (37.3%). Used intravenously in septic processes, rheumatism, etc., 5-10 cm³ of a 0.2% solution per infusion. 7. Cuprocollargol, Cuprocollargol, a preparation containing 0.01% copper and 0.03% silver; used in the same way as other colloidal silver preparations; the presence of two metals in it, according to some authors, enhances its action.