OMIT.
Salicylic acid used in twenty-five cases in the form of a 20-per-cent. ointment rubbed into the skin. In most of the cases the therapeutic effect was most decided Hasenfeld (Pester Med.-chir. Presse, No. 47, '04).
In articular rheumatism the following ointment is valuable:— 3 Salicylic acid, 45 grains.
Oil of turpentine, '/, drachm.
Adeps lame, 5 drachms.
Lard, 5 drachms.
This is spread over the parts, and a dressing of absorbent cotton applied and covered with any impervious material. Bourget (Jour. des Prat., No. 29, '93).
Many authors prefer the use of the salicylate of sodium, which is commonly given in solution, 1 to drachms or even 2 drachms being administered. It has the same effect on the disease as the pure acid.
The amount of salicylate of sodium necessary in the treatment of rheuma tism may be decidedly lessened by the simultaneous use of hot baths. The pa tient is bathed in water having a tem perature of from 100° to 105° F. every morning. This is followed by the ad ministration of from 15 to 23 grains of salicylate of sodium. At first from 40 to 60 grains per diem are needed; later from 30 to 40 grains suffice. Moritz (.Med. Week., ii, p. 439, '94).
Use of liberal quantities of the so dium salicylate recommended in acute articular rheumatism. It should be given in divided doses: grains every two or three hours until the de sired relief is obtained. Henri Huchard (N. Y. Med. Jour., Jan. 12, '95).
Ammonium salicylate is valuable in the treatment of rheumatic affections. It is best given in milk, and is usually well borne. It is the best method of ad ministering the salicylates for ordinary purposes, as it is much less depressing in its action than the other salts of sali cylic acid. Wood (Univ. Med. Mag., Jan., '95).
Several cases of both acute and sub acute rheumatism successfully treated with strontium salicylate, given in doses of from 7 to 15 grains every three hours. Eshner (Phila. Polyclinic, Aug., '95).
In acute rheumatism it is not best to give large amounts of the salicylates, for they have a depressing effect upon the patient. It is well also to combine
a little colchicum with the salicylates. Chloride of ammonium and acetate of potash, 10 to 15 grains each every two hours, have been used with good results. Robinson (Med. Rec., Feb. 1, '96).
Grave consequences may result from the employment of sodium salicylate in acute rheumatism with visceral local izations, for it neither cures nor pre vents them, but may favor production. The drug should be suspended when de lirium sets in before the diagnosis of cerebral rheumatism is established, or if the delirium be of an alcoholic or hys terical nature, or result of any intoxica tion. In cardio-pulmonary complica tions the same is true. Salicylates lower the fever and relieve pain, but do not influence at all these localizations. By persisting in their employment, in volvement of the myocardium is hast ened. Jaccoud (Lyon Med., Mar. 14, '97).
In the rheumatism of children full doses of sodium salicylate are not re quired; and they may be harmful from their depressant effects. The milder drug, salicin, may be substituted in most cases in doses of a to 20 grains; or quinine in doses of 1 to 3 grains every four hours. In each case an alkali, so dium or potassium citrate, should be combined and given in doses according to age. The use of depressant drugs— as antipyrine, antifebrin, and aconite— with a view of lowering temperature cannot be too strongly deprecated.
Gibson found that cases of acute rheu matism treated by rest escaped perma nent heart-lesion iu the proportion of two to one compared with those per mitted free action. When pericarditis supervenes, if there is much pain and distress, one or two leeches may be ap plied to the prmcordia. The most effect ive local application is that of the ice bag.
In the deadly form of cardiac inflam mation persistent, recurrent, subacute endocarditis, and pericarditis, opium, digitalis, and strophanthus, with an al kali, are the drugs of most service. Al cohol is also a most useful agent.