Natrum Salicylicum

Authorities. 2, Brit,. Med. Journ., quoted by the Review, p. 376 (Hahn. IMonth., vol. xiii, 1877, p. 56) ; 3, A. 1). L. Napier, M.B., Practitioner, vol. xviii, 1877, p. 411, an old gentleman, for rheumatic affections of the wrists and ankles, took 20 grains every three hours for more than a week ; 4, John A. Erskine Stuart, ibid., p. 425, effects of a 15-grain dose; 5, Weckerling, Deutsche Archiv fur Khu. Med., vol. xix, 1877, p. 319, a woman, who had formerly suffered from hemoptysis and pleuritis with effusion, and now continued to have fever, took several evenings 5 grams at a dose, but this day took 15 grams, at 1 p.m. ; 6, Helen, iErz. lutell. Blatt., April, 1878 (Loud. Med. Rec., May, 1878, p. 211).

Urine passed after three hours kept fresh and fiee from ammoniacal odor, and perfectly clear when exposed to the air for ten days,^—The patient was a woman, aged forty years, whose hearing was supposed to be impaired. She was not subject to giddiness. It was her first attack of acute rheumatism, and there was no cardiac affection. On January 26th, Salicylate of soda Avas commenced in doses of 25 grains every three hours. On the 28th she complained of noises in her ears, deafness, and giddiness, which the next day had increased so much that the drug Avas omitted. The following day the giddiness Aas much less, and by the 31st had almost gone. On February 6th the same dose was resumed ; on the 7th the same symptoms Averse complained of. The noises in the ears Averse constant; a Avatch AAas heard only at tAvo inches distant from each ear, and Avas not heard at all on either side Avhen in firm contact Avith either zygoma or mastoid process. A tuning-fork on the vertex anus heard fairly Avell, but the sound Avas not increased by closing tbe ears. The giddiness Avas slight and indeterminate as long as she lay still, but Avas very considerable and definite Avhen she raised her head or sat up. Objects before her all seemed moving to the right. On the 8th these symptoms continued, and the Salicylate Avas discontinued. On the 10th the giddiness Avas gone, and she could hear the Avatch at a distance of six inches from each ear, and could hear it, although faintly, in contact Avith the zygoma or mastoid process, but not Avhen in contact Avith the parietal eminence. On the 23d the Salicylate AAas resumed, and eighteen hours after its resumption deafness and giddiness had returned, Avhich again ceased a day or tAA’o after discontinuance of the drug. When the patient Avas convalescent, a careful examination of the state of hearing revealed very little abnormality, the only difference being that the Avatch in contact Avith the skull Avas not quite so distinct on the right side as on the left. In another case I have seen similar symptoms of deafness and definite vertigo produced by Salicylic acid,^—Vomiting; unconsciousness, Avith at times Avild delirium, from Avhich she recovered Avith loud cries; great heat; dyspnoea; difficult hearing (after tAvo hours); pulse 120 (the previous day it had been 92). The most remarkable symptom Avas tbe respiration ; it Avas someAvbat slower than it had been before, being nov 28, Awhile the day previous it Avas 32; respiration Avas so noisy, that it could be heard in the street; Avhen the dyspnoea Avas most violent she had to be supported in a half sitting posture, gasped for air; respiration AAas exceedingly forcible; there Averse no objective signs of dyspnoea, like retraction of the chest, of the clavicular fossae, or of the hypochondria; the respiration continued so difficult that it Avas surprising that a patient so Aveak could breathe Avith such force. Diarrhoea; great thirst; difficult hearing (second day); no SAveat (first and second days),^—C. K., a house painter, aged forty-five years, had rheumatic inflammation of the elboAV and knee-joints. The pulse was intermittent throughout the course of the case, raising the suspicion of a fatty heart, which Avas further indicated by the pasty appearance of the patient, and by his acknowledged addiction to alcoholic liquors. During the first ten days, Salicylate of soda was given in hourly doses of 7.7 grains (0.5 gram) without any effect. Thereupon the dose Avas increased to 60 grains (4 grams), with the following result. Soon after this first dose Avas given, there came on intense tingling and itching of the skin. The left side of the face, the loAver extremities, and the right side of the chest Averse diffusely reddened, Awhile both eyelids, the upper lip, and a great part of the legs Averse slightly oedematous. The pulse stood at 90, temperature at 101.8° F., and the urine Avas slightly albuminous. At the same time all pain in the affected joints had vanished, bad disappeared, and the pulse and temperature had fallen respectively to 80 and 100° F. In order to ascertain how far these symptoms were the result of the treatment, it was determined to repeat the dose at the next opportunity. The patient continued free from pain for the next three days, but on the fourth day the articular pains returned with such severity that the patient himself begged for “the large powder.” 60 grains were given ; after fifteen minutes severe burning pain in the frontal integument supervened, and five minutes later strong itching on the back of the right hand. In half an hour a marked eruption of urticaria was established over the greater part of the body, especially the legs and abdomen, with some cedematous swelling of the arms, eyelids, etc. This disturbance moderated in the course of two or three hours, and had completely subsided the next day. Subsequently, several smaller doses were administered without producing any of the above effects, and the patient recovered. After his recovery the patient consented once more to take the larger dose, and the result was precisely the same as before,®.—Became very deaf, had ringing noise in the ears; severe headache; thirst; loss of appetite; felt dull and heavy,®.