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Synonym—Subnitrate of Bismuth.
This salt is formed from purified bismuth, by the action of nitric acid in the presence of distilled water.
Physiological Action—It is a mild and soothing agent in its local influence upon the skin and inflamed mucous surfaces. Internally its influence is confined almost exclusively to the gastro-intestinal mucous membranes.
The agent is not entirely devoid of toxic properties, when applied very extensively to large, open wounds. It sometimes produces poisonous effects owing to a not uncommon adulteration with a salt of arsenic. It has produced gastro-intestinal irritation and symptoms or arsenic poisoning. Desquamative nephritis with albuminous urine has occurred from its free and long continued use.
In all cases where its use is persisted in, it produces a greenish or black discoloration of the feces, and an odor of garlic upon the breath which is due partly to decomposition of the salt and partly to the presence of tellurium.
Therapy—It is applicable in all cases of vomiting from local irritation. It has long been in use for this purpose. It is one of the best known remedies in chronic catarrh of the stomach with much nausea and the secretion of large quantities of mucus. The writer has used an arbitrary combination of this salt with an equal part of ingluvin in all cases of irritation of the stomach. The combination is much more serviceable than either agent alone, and is applicable to very many conditions particularly to the summer complaints of children with extreme and persistent nausea.
In these cases it is well to add half a teaspoonful of this powder to half a glass of water, and after thoroughly stirring it, to administer a teaspoonful every few minutes for an hour or two, all other remedies being suspended. When the irritation is controlled, the agent should be continued for a short time in alternation with other necessary remedies.
Its influence is not confined to the stomach alone, but extends to the intestinal mucous surface, where it materially assists in controlling many for of diarrhea through the astringent properties of the bismuth.
In the use of bismuth subnitrate for the cure of chronic gastric catarrh, large doses are necessary. Fifteen grains of the pure salt, given once in three or four hours, is of more service than five grains often repeated.
It is useful also in pyrosis, in gastric flatulence and in extreme acidity of the stomach especially from the presence of lactic and butyric acids.
In diarrheas where extreme relaxation is present with lack of tone the intestinal membranes, this agent is of but little value as it lacks tonic properties.
When the tongue is clean and the bowel movements are watery, Liquor Bismuth is indicated in dram doses, after each stool.
As an external application, bismuth is one of the most valuable remedies. It forms a most perfect dusting powder for chafings and excoriations especially in young infants. It is applicable also to the skin of the face when easily chapped or when sensitive from shaving, and to chapped hands.
Incorporated in an ointment of lanolin, is is excellent applied to cracked and fissured nipples. It should be kept constantly applied, any excess being wiped off before nursing, and the ointment fully reapplied afterward.
This ointment is most superior as an application to superficial burns. After the pain and heat are reduced by the application of a carbonate, if this ointment is kept constantly applied to the burned surface, the healing is very rapid and the cicatrix is in some cases scarcely perceptible, usually no contraction of tissue taking place.
Although antiseptic properties are not ascribed to the remedy, pus is not likely to form when it is used. Where an active antiseptic is needed, boric acid may be incorporated with it. An ointment of this character is applicable to eczema of the moist variety. If applied, and the surface closely covered, healing in some cases takes place with great rapidity. In eczema of the scrotum and anus, this agent is applicable, and in piles of an acute or sub-acute character, it renders excellent service. It is applicable to fissures of the anus and to ulcerated conditions within the rectum, especially if there are offensive andirritating discharges.
The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.