Chapter 87

Antimony (Sb) and its compounds are among the oldest known remedies in the practice of medicine.82,126 Because of a strong chemical similarity to arsenic, the features of antimony poisoning closely resemble arsenic poisoning (see Chap. 88), and antimony poisoning has many features in common with other metal poisonings. Although relatively uncommon, antimony poisoning still occurs, usually as a complication of the treatment of visceral leishmanias.75 Acute overdose represents an even more rare but potentially lethal event.112

Objects discovered during exploration of ancient Mesopotamian life (third and fourth millennium BC) suggested that both the Sumerians and the Chaldeans were able to produce pure antimony.82,126 The reference to eye paint in the Old Testament suggested the use of antimony.82 For several thousand years, Asian and Middle Eastern countries used antimony sulfide in the production of cosmetics, including rouge and black paint for eyebrows, also known as kohl or surma.78,83 Because of the scarcity of antimony sulfide, lead replaced antimony as a main component in more modern cosmetic preparations.

One of the first monographs on metals, written in the 16th century, included a description of antimony.118 The medicinal use of antimony for the treatment of syphilis, whooping cough, and gout dates to the medieval period. Paracelsus was credited with establishing antimony compounds as therapeutic agents and increasing their popularity. In spite of being aware of its toxic potential, many of the disciples of Paracelsus enthusiastically continued the use of antimony.82 Various antimony compounds were also used as topical preparations for the treatment of herpes, leprosy, mania, and epilepsy.126 Orally administered tartar emetic (antimony potassium tartrate) was used for treatment of fever, pneumonia, inflammatory conditions, and as a decongestant, emetic, and sedative, but it was abandoned because of its significant toxicity.18,38,54,66 The use of antimony as a homicidal agent113 continued well into the 20th century (Chap. 1).

The current medical use of antimony is limited to the treatments of leishmaniasis and schistosomiasis, and to sporadic use as aversive therapy for substance abuse.112 Pentavalent compounds are used because they are better tolerated. In the endemic regions of the world, generic pentavalent antimonials remain the mainstay of therapy because of their efficacy and low cost; however, the growing incidence of resistance may reduce future use.87

Some contemporary homeopathic49 and anthroposophical107 practices still recommend use of antimonial compounds as home remedies; however, these practices are rare.82,126 In spite of its anticancer effects in vitro,38 there is no current oncologic use of antimony.

The elemental form of antimony has very few industrial uses because of its physical limitations, particularly the fact that it is not malleable. In contrast, its alloys with copper, lead, and tin have important applications. Various antimony compounds can be used in the production of ...

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