SALICYLIC AND BENZOIC ACIDS - GOUT MEDICINAL TREATMENT.
Sodium salicylate is the form in which salicylic acid is usually exhibited. Too great care cannot be taken to procure a pure specimen of the drng. Many of the failures in its use are the result of impuri ties in the medicine, as well as of timidity in its administration. Inexperienced physicians who give small doses of an impure prepara tion have very little idea of the remedial effects that can be obtained from the employment in sufficient quantity of an unadulterated article. It is in the acute stage of gout that its action is most conspicuous, when given in doses of fifteen to twenty grains every two hours. In hemicrania; in trigeminal neuralgia, gastro-enteric pain, and other forms of neuralgia that are dependent upon the gouty diathesis, it is one of the most efficient agents for the relief of suffering. It is most effectual when administered in connection with the mineral acids. Thus in hemicrania the patient should take fifteen to twenty drops of dilute nitro-hydrochloric acid after each meal, and ten grains of sodium salicvlate before meals. In tic douloureux the sodium salt may be administered every two or three hours, with great advan tage in plethoric cases. But in atonic and chronic cases colchicum and other hepatic evacuants will probably be needed in addition to the alkaline salt. Haig has also called attention to the fact that it is only in typical cases of gout and rheumatism that the salicylates are beneficial. In gonorrhoeal and traumatic affections of the joints
they are useless, apparently because in such cases there is no surplus of urates to be evacuated.
The well-known action of benzoic acid, by which it enters into various combinations within the tissues, and is finally eliminated as soluble hippuric acid in the urine, has led to its therapeutical exhi bition in arthritic conditions. Contained in vegetable food it is the active agent by reason of which the graminiverous mammalia always excrete hippuric acid instead of uric acid. The alkaline hippurates are very soluble, while the urates are quite the contrary. Upon the basis of these observations, benzoic acid and its sodium and ammo Mum salts have been employed with considerable success as elim inants of uric acid. These preparations may be given in doses of ten to twenty grains every three or four hours. They are easily tolerated by the alimentary canal and by the urinary passages. They are especially useful in catarrhal conditions of the bladder, and when there exists a tendency to offensive decomposition of the urine in the vesical cavity. Hence their utility in cases of senile gout, in which such complications are not infrequent.