On the treatment of acute rheumatism by salicylate of soda.

  • Sharkey, Seymour John (Sir)
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of acute rheumatism by salicylate of soda. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    In the last twenty-four hours one pint and three quarters of urine passed of sp. gr. 1038. No albumen; marked reaetion with perchloride of iron. The temperature never rose again^ and the patient had no return of pain or other rheumatic symptoms, and was discharged on January 28th, The salicylic acid disappeared from the urine seventy-one hours after the last dose was taken. The patient took sixteen doses of the medicine in the two days, making in all 320 grains. When the drug is given in these quantities the first result usually is diminution of pain, and so rapid is this that it often follows the first or second dose. With it the tempera- ture also is reduced, and there is profuse perspiration. The patient generally complains too of deafness and noises in the ears. These effects are pretty constant, and may be accom- panied by nausea or even vomiting, so that the medicine has to be stopped; the latter, however, is 'rather an exceptional occurrence. The swelling and redness leaves the joints much less rapidly than the pain, and the tongue often remains furred long after the patient feels quite comfortable, and is almost free from fever. Salicin has the advantage of producing to a far less extent, and often not at all, the unpleasant phenomena which are pretty constant when salicylate of soda is given; but its power of reducing the temperature seems to be much smaller than that of the salicylate, even when given in the same quantities. A not at all uncommon accompaniment of the internal use of salicylate of soda is a profuse miliary eruption, which very often becomes pustular. Sometimes vesicles of a considerable size, filled with pus, are distributed over the body, and even a succession of very troublesome pustules may result. The greater frequency of the miliary eruption when this treatment is employed, and its greater proneness to suppuration, make it probable that it is in some way due to the salicylate, especially when we remember what profuse diaphoresis is produced by the drug. In one case a general erythema preceded the miliary eruption, and in another urticaria occurred, but I have onlv seen one case of each. •r In some cases the drug seems to affect the nervous system more especially, and delirium may be very rapidly produced.