This section is from the book "Dental Medicine. A Manual Of Dental Materia Medica And Therapeutics", by Ferdinand J. S. Gorgas. Also available from Amazon: Dental Medicine.
Derivation - The metal Bismuth - Bismutbum, Formula Bi, from which the subnitrate is obtained, is found native in Europe and America, and generally in combination with sulphur and oxygen. It fuses at 510° F., and is brittle and pulverizable. It is employed in the dental laboratory for making fusible metal alloys for dies and counter-dies.
The Subnitrate of Bismuth is obtained by dissolving the metal bismuth in dilute nitric acid, and converting the nitrate thus formed into carbonate, by adding a solution of carbonate of sodium, which is then dissolved in nitric acid and the nitrate of bismuth aeain formed, which is washed in water and the nitric acid removed by ammonia. Such a process frees it from the arsenious acid which metallic bismuth generally contains. Subnitrate of bismuth is in the form of a heavy, white powder, with a faint acid odor and slightly metallic taste, and is soluble in water. Large quantities are poisonous, with symptoms of arsenical poisoning.
Subnitrate of bismuth is sedative, astringent and alterative. Owing to the formation of a sulphide, it coats the tongue black, and its continued use may give rise to the formation of a bluish-red line on the gums, similar to that resulting from the use of lead, except that the line is wider and deeper in color. In proper doses, it promotes the appetite and increases the digestive power. Being somewhat astringent, it affects the intestinal movements, and can be detected in the blood, urine, and other secretions.
Subnitrate of bismuth is employed in atonic dyspepsia, gastric irritations (milder forms), pyrosis, gas-trodynia, ulcer of the stomach, diarrhoea from debility, etc., chronic laryngitis, epilepsy, ringworm (in form of an ointment to lard chronic skin diseases, chlorosis, when iron is not tolerated, etc., etc. If not well borne by the stomach, it may be combined with aromatic powder, or if alkalies are indicated, with chalk and magnesia.
Bismuthi subnitras is also employed as an antiseptic dressing for wounds, to promote primary union. The subnitrate is held in suspension in water, in the proportion of 10 per cent., and during the operation the wound is, from time to time, sprinkled with the solution, and afterward sealed with a bismuth paste, and the subsequent dressings made in the same manner.
Of subnitrate of bismuth, grs. v-x to in powder or emulsion.
Subnitrate of bismuth is a valuable internal remedy in aphthae, mercurial salivation, painful ulcers of the 20 mucous membrane of the mouth, vomiting, cholera infantum, and diarrhoea of children during painful dentition. It is best given in milk, and before meals.
For cancrum oris, after using a disinfecting solution to cleanse the gangrenous part, the topical application of subnitrate of bismuth, every three hours, corrects the fetor, arrests the progress of the gangrene, and hastens cicatrization.
For Vomiting and Painful Digestion of Teething Children, Acidity and Pyrosis.
Mucil. acacise ....
Aquae menthae pip. . . Signa. - A tablespoonful for adults and proportionate quantity for children, 3 or 4 times a day.
For Gangrene of Mouth (Cancrum Oris).
Bismuthi subnitras (powd.) Signa. - Applied to ulcerated surface, and covered with absorbent cotton.
For Diarrhoea of Dentition.
Bismuthi subnitrat. . . gr. 1x
Extract rhei fluid . . gtt. viij
Syrup rubus ....
Elixir aurantii . . . Signa. - A teaspoonful 4 to 6 times a day. Proper feeding - bailey water, milk and lime water. Starchy food prohibited.
For Indigestion, Cholera Infantum, Vomiting and Diarrhaea, Disordered Digestion.
Bismuthi subnitrat., grs. iij to vj for children, every hour, or grs. v to x or xv for adults.
Dermatol is a basic gallate of bismuth in the form of a fine saffron-yellow powder, odorless and innocuous. It is insoluble in water, alcohol, and ether; not hydroscopic, or otherwise affected by air or light. It resembles iodoform in appearance, and possesses astringent, antiseptic and dessicant properties. It is used externally in wounds, ulcers, and inflammations of mucous membranes, and is of especial value in lesions, attended by profuse secretion, as eczema, burns, ulcers, wounds, and diseases of the eye and ear. Internally, it is employed in diarrhoea, etc. As an antiseptic it prevents putrefaction, and also the development of bacteria when used as a 1.10 per cent. solution. Dermatol may be used as a powder, as liquid and paste, in emulsion of collodion, glycerine, and essential oils, and as an ointment with lanolin wax, oxide of zinc, and paraffin.