Eng., Bismuth Subsalicylate.

Average Dose

8 grains (0.5 Gm.).

Therapeutic Action

Antiseptic, astringent, protective.

Uses

Internally used in the treatment of gastritis, hyper-chlorhydria, gastric ulcer, diarrhea, dysentery, etc. Externally, in powders or ointments in the treatment of ulcers, burns, miliaria, eczema and many other skin conditions. The subnitrate (33 per cent.) with petrolatum (Beck's Paste) is used for chronic suppurating sinuses, cavities, etc., particularly of tuberculous origin.

Administration

Internally.-The subnitrate is the salt of common choice, though the subgallate is considered more astringent, and the subcarbonate better for some forms of gastric disturbances. The tendency is to give large doses. These salts may be given dry or in mixtures, but when in the latter form, as the powders are heavy, care should be exercised that the liquid be sufficiently thick to hold the powder suspended while a dose is being poured.

The following examples show some usual combinations:

When it is desired to administer a bismuth salt alone it may be ordered as follows:

Ft. cht. no. xij.

Sig

One every four hours.

Or:

M.

Sig

Teaspoonful every four hours. (Shake-label.)

In the treatment of the intestinal disturbances of childhood when the bismuth salt does not change the character of the stool it is often combined with sulphur at the time of administration. In addition to one of the prescriptions just given, another is written as follows:

M. ft. cht. no. xv.

Sig

One with each dose of the other medicine.

In the treatment of diarrhea of typhoid fever:

M. ft. cap. no. xxiv.

Sig

One every three hours.

This could also be ordered in suspension in mucilage of acacia, syrup, etc.

Used for the relief of abdominal tympany:

M. ft. cap. no. x.

Sig

One two hours after each meal. This may be ordered in powders.

In the treatment of dysentery:

M. ft. cht. no. xij.

Sig

One every two hours.

1 Anders: Practice of Medicine.

2 Ashton: Practice of Gynecology.

3 Shoemaker: Materia Medica and Therapeutics.

In the treatment of gastric ulcer, etc.:

M. ft. cht. no. xv.

Sig

One in a glass of milk three times a day.

In the treatment of diarrhea, dysentery, nausea, etc.:

Sig

Tablespoonful every three hours until relieved. (Shake-label.)

In the treatment of diarrhea of typhoid fever:

M.

Sig

Teaspoonful every three hours. (Shake-label.)

In the treatment of acute intestinal indigestion:

M.

Sig

Two (2) teaspoonfuls in water every two hours. (Shake-label.)

In the treatment of enterocolitis:

M.

Sig

Tablespoonful every three hours. (Shake-label.)

1 Hughes: Practice of Medicine.

2 Ibid. 3 Ibid.

Externally

Bismuth Subnitrate is extensively used as a local application. It is prescribed either alone or with other agents.

The following will illustrate:

As a local application in the treatment of impetigo, fever blisters, etc.:

M.

Sig

Apply twice daily.

In the treatment of herpes, bromidrosis, etc.:

M.

Sig

Apply.

In the treatment of erythema venenatum:

M.

Sig

Apply in a thin layer.

In the treatment of ecthyma:

M.

Sig

Apply on a cloth twice daily.

In the treatment of dermatitis:

M.

Sig

Apply locally.

1 Shoemaker: Materia Medica and Therapeutics.

2 Ohinann-Dumesnil: Diseases of the Skin. 3 Ibid.

4Ashton: Practice of Gynecology.