UNGUEN TEM CREDE. — Unguentum Crede is a salve containing 15 per cent. of soluble metallic silver. The greatest care is needed in its preparation, in or der to obtain the minute subdivision of the silver particles necessary for its ab sorption through the skin.
It is indicated in the treatment of acute suppurative processes, and should be thoroughly rubbed into the cleansed skin until it has approximately disap peared. This takes from twenty to thirty minutes. The amount to be used varies from 30 to 45 grains at each in unction.
The formula of unguentum Crede is as follows: 15 per cent. of soluble silver is incorporated in lard by the same method as is the mercury in gray oint ment, and to the product 10 per cent. of was is added. The ointment is flavored with benzoinated ether. From twenty to thirty minutes are required for inunc tion. This ointment is useful in acute suppurative processes, as phleginon. lym phangiectasis and lymphadenitis, septi ceemia, commencing osteomyelitis, phleg monous angina, furunculosis, erysipelas, puerperal fever, and gonorrhoeal and ar ticular rheumatism. In general sepsis, or when inunctions are not practicable, it may be given internally as a pill: soluble silver, V. grain; sugar of milk, 1 grains; glycerin, minims, with sufficient water. Two of these may be administered twice or thrice daily, fol lowed by from 3 to 6 ounces of boiled water or tea.
Pencils of 3 grains each are useful for fistula. In solution, 1 or 2 to 10,000, it may be used for irrigation. Of the strength of 1 to 500-2000, in severe sep sis it can be administered intravenously after the method employed by Baccelli for mercurial solutions. B. Crate (Klan. Cher. Woch., Nos. 14, 15, '98).
Personal experiences with soluble metallic silver in the treatment of the septic infection of wounds are summed up as follows: 1. In soluble metallic silver we possess a valuable remedy for the successful treatment of blood poisoning caused by septic infection, when the diagnosis is made correctly, and while secondary af fections are still absent.
2. The method of the intense silver therapy is suitable for both acute and chronic sepsis and for furunculosis.
3. It is most energetically exhibited by means of inunctions, with the un guentum Crede, in which, by cutaneous absorption, the medicament is directly introduced into the circulation.
In the blood the formation of the powerfully bactericidal silver salts effects a general antisepsis and a disinfection of the entire organism. Oscar Weiler (Dent. med. Woeh., Oet. 6, '98).
Credos silver ointmeitt has been found valuable in puerperal sepsis. This oint ment is used once in twenty-four to thirty-six hours iu acute eases and in chronic eases twice daily. It is rubbed into the body at some distance from the point of infection, and should be thor oughly carried into the skin and sub jacent tissues. Results of the treatment are immediate improvement in the symp toms, beginning within from three to ten hours. In a personal ease of septic ab sorption when the patient's condition was critical, between 1 and 2 drachms of Credos silver ointment were rubbed into the inner surface of the thigh, and re peated on the following morning. A rapid and marked improvement followed, the patient's temperature falling to nor mal and her pulse gradually improving. Five days afterward there was again fever and rapid pulse, when two inune tions were given twelve hours apart. After this intmetions were given daily in small quantity for four days. and then at intervals. Altogether about ounces of the ointment were employed. Patient made a good recovery. Jones (Obstetrics, No. 2, '99).
Colloid silver is tasteless and unirri toting and is a powerful antiseptic. The streptococci combine with it chem ically and a silver salt is formed which is exceedingly destructive to germs. It is of great value, particularly in infected wounds. The usual forms of antiseptic solution, such as mercury and iodoform, are toxic, but silver is harmless. It is useless when administered by the mouth or by subcutaneous injections; the only method of administratidn is by inunc Con. It may be given by intravenous injection. It is employed in acute rheu matism, gangrene, typhoid fever, scarlet fever, and septic complications. Experi ments upon animals show quite as favor able results as in the human. The silver is absorbed and eliminated rapidly, and the inunetions must be repeated three or four times a day. Credo (Berliner klin. Wochen., Sept. 16, 1901).
The intravenous plan is the best. From subcutaneous injection absorption is slow and silver is often deposited. Per os the best method is to mix the colloid silver with mucilage. In this way 50 per cent. can be recovered from the stools in the original form. This method is of great use in intestinal dis orders. After a large dose, injected in travenously, silver can be demonstrated microscopically in the liver, spleen, and intestine, but not in the kidney. Beyer (.1Iiin•heuer med. No. 8, 1902).