I have of late had ample opportunity to test both piperazin and
piperazin hydrochlorate as solvents of uric acid. Hitherto I have used
the salts of lithium and potassium in the uric acid diathesis, but will
now certainly always use the new solvent in preference to either of
these. I have taken particular pains to watch the action of the drug—so
feel confident in stating that it is the best of known uric acid
solvents.
I have never noticed any toxic effects from the use of either
preparation, but prefer the hydrochlorate on account of being less
hygroscopic, although I believe piperazin can now be procured in
lozenge-form in glass tubes, which greatly lessens the hygroscopicity.
I will now briefly give particulars of three cases of uric-acid
diathesis treated with the medicine.
The first, a man aged 36, weight, nearly three hundred pounds, suffered
much renal pain, with occasional symptoms of small calculi passing along
ureter. The urine had very acid reaction. The microscope revealed
numerous crystals. The murexide test likewise proved that uric acid was
present in abundance. This patient, wishing to become thin, was put on a
beef diet, no potatoes, few vegetables, etc., just the diet to increase
the uric acid. He was put on the solvent treatment, giving twelve
grains, divided into three doses daily. Each dose was given in a
tumblerful of vichy water. In a few days the urine became neutral in
reaction; the loin-pains left; also the constant desire to micturate
caused by the irritation of the uric acid. The beef-treatment was kept
up for several weeks and the weight was reduced by 11 pounds. This case
shows that, although no precautions were taken to diminish the formation
of uric acid, but the contrary, piperazin was sufficient to dissolve the
crystals.
The second case was that of a man aged 50, weight, 215 pounds. He
complained of pain, described as “burning” in loins; also a dull ache in
bladder, frequent desire to micturate; sometimes urine was mixed with
blood. Without altering the diet at all, which was always a liberal one,
including beer every day, all the disagreeable symptoms disappeared
while taking piperazin hydrochlorate. On several occasions there was a
return, in a modified form, of the symptoms, but after a few doses of
the drug they always disappeared.
The third case was that of a man 60 years of age, who had for years felt
pain in kidneys, along ureter and in bladder, and never got much relief.
I prescribed for him 5 grains of piperazin to be taken three times daily
in large quantities of water. After a week’s treatment the pains had
left, and he was better than he had been for years.
Gruber has used it with good results in diabetes. He considers that the
action of the drug in this disease is inhibitory to the transformation
of glycogen into sugar.