The Journal of the American Medical Association for Nov. 22, 1919, says through a staff writer that the rapidity with which “mineral oil” (petrolatum) has conquered the globe has been phenomenal. It is now a most extensively used substance and if its sale were any indication of its medicinal value, we should have to consider it one of the most valuable of medicament’s. Petrolatum is a bland, odorless, tasteless and colorless liquid, indigestible as well as incapable of decomposition by bacteria; hence it cannot become rancid. It is not absorbed, therefore it cannot produce poisoning in any dose. A pint of liquid petrolatum has been given in a few hours without unto-ward results. While it is merely of temporary value in habitual chronic constipation and possibly may still further increase the intestinal sluggishness by lessening the amount of intestinal exercise, it seems to have an actual curative effect in certain conditions, as, for instance, in spastic constipation (spasm of the intestine but frequently used as meaning a contracted colon at some point) to which by lessening the irritation, it may ultimately succeed in lessening the irritability.
Wherever it is desired to soften the feces petrolatum is indicated.* To speak of this action as lubrication is hardly correct. Lubrication depends upon the formation of an oil film such as it is impossible to apply to a water-soaked membrane. When an excess is used it generally gives rise to the much complained of leak, which may occur even with small doses.’
On this point Kellogg says that paraffin oil has the very important quality of being a highly active solvent of the poisonous waste with which it comes in contact and takes up a considerable portion of the toxins found in the intestinal tract. When paraffin is used it may always be seen in the feces, showing a brownish or blackish color, due to the substances it holds in solution. In a laboratory test made by a competent chemist it was found that when paraffin oil was shaken with a watery solution of indol (a poisonous product of the colon) more than half the indol was quickly taken up by the paraffin. The use of half an ounce of paraffln at bedtime and half as much more an hour before each meal will generally in a few days change a putrefactive condition completely. Its effect in hemorrhoids has been found very favorable and the cases requiring operation greatly reduced. Another special advantage the oil has is that the beneficial effects are not diminished by continued use as is the case with almost any other laxative. It has long been known that the workmen engaged in paraffin works are especially subject to cancer. A commission appointed by the British Government to make a special study of the subject showed by the report of its specialist, Dr. H. C. Ross, of the Lister Institute, London, that paraffin oil contains substances associated with anthracene (a hydrocarbon derived from coal tar), which are believed to be, under favorable circumstances, capable of producing cancer.’
An investigation of mineral oil was made under the auspices of the American Medical Association and a report published March 6, 1915, by W. A. Bastedo, of New York, of the Committee, from which it is seen that the committee started its work by collecting three kinds of liquid petrolatum: A light “Russian” oil; a heavy “Russian” oil, and an American oil which was markedly fluorescent (having surface colors). The collaborators were advised that the reports should furnish information as to the size and frequency of the dose, the agreeableness of the taste, the effect on the stomach, number and character of stools, degree of admixture of oil with other material, degree of leakage, and need of other cathartic measures.
From eight clinical reports submitted the following conclusions were drawn:
Dosage.Half an ounce to three ounces a day. In the same patient the same amount of each of the oils was required.
Frequency of dose.The same amount daily seemed as efficient when given in one dose as when given in divided doses two or three times a day.
Stomach tolerance.In about 20 per cent of the patients the oil produced a slight degree of nausea. This is most likely in patients who have gastric stagnation with retarded emptying of the stomach. All the oils acted the same in this regard. Vomiting was reported in two cases.
Effectiveness.To produce one or two copious stools a day the required dose varied considerably (as stated above) but there was no difference on account of the specific gravity or character of the oils.
Character of stools.They were soft, usually formed, sometimes not, obviously greasy. They had a peculiar odor described as sour. Their consistency varied with the dose but was the same for the different kinds of oil.
Admixture of oil with other ingredients.Generally well mixed but from time to time a patient would pass free oil. This occurred with all varieties of oil. It necessitated reduction of the dose and if then the bowels were not active enough, the administration in addition of cascara, aloin, etc.
Leakage.A disagreeable feature complained of by many was that when enough oil was taken to move the bowels there was a sufficient leakage to sometimes stain the clothes.
Summary.So far as the therapeutic (remedial) results are concerned the differences in the action of the three varieties of oil are too slight to be of importance. From these findings it would appear that a satisfactory standard of the U. S. Pharmacopeia might permit the use of Russian or American oil, if suitably refined.