Salicylic acid diminishes the vital ac tivity of protoplasm. It is a specific in acute articular rheumatism and in gout, showing itself by a special action exer cised not upon a cause still unknown in its real essence, but on account of the power of the anatomical element to sus tain this cause and react under its influ ence. This, however, does not exclude a true specific action upon a cause still unknown, analogous to that exercised by quinine upon the blood-parasites of paludism or mercury upon syphilis. Be sides this specific action, which may be called a special antiseptic, there is a gen eral antiseptic one, which may be useful in variola, diarrhma, diphtheria, and orchitis after blennorrhagia. M. G. Pon chet (Nouv. Rem., No. 3, p. 57; No. 4, p. 89, '96).
Poisoning by Salicylic Acid. — The symptoms of poisoning by this drug are those of an irritant poison. After the ingestion of a toxic dose nausea follows with a burning sensation in the throat, vomiting, and gastric irritability. There is headache, with great distress in the head and serious disturbances of hearing and vision (deafness, ptosis, strabismus, amblyopia, dilated pupils); excessive restlessness, passing into delirium; slow, laboring pulse; at first accelerated and deepened breathing, with extreme dysp mra (later feeble and shallow); olive green urine; occasionally albuminuria, hwmaturia, or even suppression of the urine. Sweating is usually profuse. Local evidences of vasomotor depression may be present, such as rapidly-appearing bed-sores at points subjected to pressure and transitory dark-colored spots over the body (Wood). Post-mortem exami nation in a case of death from salicylic acid revealed a breaking-down of the blood, visceral congestion, and ecchy motic spots upon the serous membranes..
Case of a 51-year-old man who had been treated in years preceding for ne phritis. Sixty grains of salipyrin were given in four doses. On the next day an eruption appeared upon his scrotum,. which became a large, markedly cedema tous, infiltrated, red surface. The follow ing day the patient, against advice, re peated the drug. Necrosis of the affected areas followed, and a deep wound-cavity was left which healed under sublimate solutions. The urine showed a notable amount of albumin. Fedor Schmey (Then Monats., H. 3, S. 175, '97).
In some cases the mental disturbance persists for a week or more. The acid acts very unfavorably upon drunkards, violent delirium being a common and early symptom (Wood). When death oc curs, it is preceded by great dyspncea and general convulsions, and is due to re spiratory paralysis.
Erythema with oedema, intolerable itching and tingling of the skin, and fever have been caused by large doses of the sodium salt. Other observed effects upon the skin are vesicles, pustules, and patches of ecchymosis.
A form of chronic poisoning may oc cur in persons exposed to inhalation of the acid, which is marked by a subacute inflammation of the air-passages attended by congestion, swelling, and edema of the mucous membrane. The swelling of the tracheal mucous membrane may be so marked as to cause stenosis. In these cases iodide of potash has been found beneficial.
Treatment of Poisoning by Salicylic Acid.—The treatment for poisoning by this drug is that for an irritant poison. It will be well to wash out the stomach with warm water and administer strong coffee. Further treatment will be indi cated by the symptoms present.
Therapeutics.—Salicylic acid and the salicylates may be used remedially for their antiseptic, antifermentative, anti pyretic, antirhcumatic, antipruritic, or autihydrotic property.
RHEUMATISM.—As a remedy in acute articular rheumatism, salicylic acid and the salicylates hold first rank by reason of their prompt and uniform relief of the pain, fever, and other symptoms in cident to this disease. Several methods of medication are suggested. Ten to 20 grains may be given every hour until 1 drachm is taken, the same dosage being repeated the following day. Fifteen to 20 grains may be given every four hours until marked physiological symptoms ap pear. Thirty to 40 grains may be given at 7 and 9 P.M., with a glass or two of milk, so that the effects are produced during sleep. An extemporaneous mixt ure of potassium salicylate may be pre pared by dissolving 3 drachms of sali cylic acid and 6 drachms of potassium bicarbonate in 2 ounces of cinnamon water, a teaspoonful of which may be given in a wineglassful of water every two or three hours. Internal medication in this disease may be supplemented by the use of lint wet with a solution of sodium salicylate, wrapped around the rheumatic joint or of an ointment of salicylic acid applied locally, or the joint may be painted with oil of wintergreen or oil of birch. Local absorption of salicylic acid results through the topical use of any of these remedies. After the subsidence of the acute symptoms the salicylates may, with advantage, be re placed by one of the alkalies; the citrate of potash and soda in doses of 30 to 60 grains at bed-time act well in the sub acute stage. In chronic rheumatism the salicylates seem to be valueless.