Bismuthum

[STITKATE OF BISMUTH.]

This is a compound of bismuth and nitric acid. Christison reports a case of poisoning with bismuth which is more fully stated in Wibmer's Toxicology.

A man took two drachms by mistake, and died therefrom on the

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ninth day. In addition to the usual symptoms of gastro-enteritis, there was a disordered condition of the nervous system, indicated by cramps of the hands and feet, disordered vision and delirium. It is deserving also of a remark that there were difficulty of breathing and salivation. A post-mortem examination showed inflammation throughout the alimentary canal, accompanied here and there by gangrenous spots ; the spinal vessels were gorged with blood, particu- larly toward the cauda equina ; there was fluid in the cerebral ventri- cles ; and the inner surface of both ventricles of the heart was red.

This case shows that bismuth exerts a most powerful specific action upon the cerebro-spinal axis, more particularly upon the spinal marrow, and through it, upon the various parts of the digestive tube.

Hahnemann has left us a few interesting provings of this agent confirmatory of the toxicological results. These provings are more particularly distinguished by the following symptoms of gastric derangement : Slight nausea, pressure at the stomach, passing into a burning pressure in the frontal region, vertigo with humming in the ears, redness of the conjunctiva, and quick, rather hard, small pulse. Vomiting with oppressive anxiety, small pulse, vertigo and prostration. Vomiting and diarrhoea, with retching and burning in the throat.

Spasmodic retching and pain in the stomach. Burning pain and oppression in the stomach, with frontal headache, vertigo, contracted, hard and frequent pulse, warm skin, coated tongue, flatu- lence, bilious stools. Frequent emissions of watery urine.

A robust man of twenty-eight years swallowed fifteen and next day twenty grains. He was attacked with headache, vertigo, pressure in the forehead, heat all over the body. The conjunctiva was considerably reddened, the pulse tense and contracted, the tongue somewhat coated. Three hours and a half after taking the drug, he experienced a troublesome pressure and burning in the stomach ; half an hour after, he belched up a good deal of wind.

A robust man of forty, swallowed forty grains at one dose. In half an hour, he had pressure at the stomach, vertigo, headache, especially in the frontal region, red eyes, dimness of sight. Tongue slightly coated, taste bitter, thirst increased, appetite gone, pulse small, tense and jerking. In one hour : burning at the stomach, violent eructations, griping in the bowels, slight vomiting of bile, and afterward a liquid, bilious stool.

Another prover took twenty grains, from which he experienced pressure at the stomach, rumbling in the bowels, frontal headache, vertigo, redness of the conjunc- tiva, eructations, burning at the stomach, bilious vomiting, oppression of breathing, increased frequency and volume of the pulse.

These symptoms show a great deal of uniformity in the action of bismuth, and reveal, to some extent, the curative range of this agent with remarkable distinctness. In

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GASTRODYNIA and even gastritis, characterized by the above- mentioned symptoms, and accompanied by symptoms of cerebral derangement, such as frontal headache, vertigo, humming in the ears, and perhaps by inflammatory irritation of the conjunctiva, bis- muth is a most valuable agent. In

DYSPEPSIA bismuth acts curatively, when there is sweetish, metallic taste ; thirst for cold drinks, with immediate vomiting of cold water taken ; burning and pressure in the stomach after eating, confined to a circumscribed, narrow spot, forcing the patient to bend backward ; nausea ; flatulency ; eructations of offensive odor ; con- stipation or offensive diarrhoea.

A gentleman, thirty-four years old, was unable to partake of any solid food for many weeks, on account of the distress which followed in his stomach and bowels. He suffered all the time from pains in his head and abdomen, and pains in the upper and lower extremities, that made him very restless. His bowels were sometimes loose, and he often passed considerable bloody water. He was greatly prostrated.

Gave him arsenic as he craved cold drinks, but this produced no relief. Gave him nux vom. with like results, and finally bismuth was administered. The first dose relieved the irritability of the stomach ; the second, given two hours after, operated favorably ; he was able to partake of a little toast, which did not distress him ; his thirst was diminished ; he had no further discharges of bloody water from the bowels. Gave him the third dose in four hours, after which he ate a piece of tenderloin and drank a cup of black tea.

He took no other remedy. He fully recovered his health and strength in four weeks, since which time he has remained quite well. (Dr. A.

E. Small.)

We know from the post-mortem examination in the above-men- tioned case of poisoning, that bismuth has a specific inflammatory action upon the internal surface of the ventricles ; and we know from our provings, that it causes violent beating of the heart. In

ENDOOAKDITIS, accompanied by inflammatory irritation of the stomach and by cerebral symptoms analogous to those which 1 have described before, bismuth may be a useful agent.

PEOSOPALGIA. — Bismuth is indicated in prosopalgia when the pain is excruciatingly severe, relieved by taking cold water into the mouth, aggravated when it becomes warm ; better from moving about.

A lady twenty-five years of age, had facial neuralgia of some weeks' standing. Worse in the morning. The pain was excruciating, burning, greatly aggravated by warmth. She could only obtain relief by holding cold water in the mouth and moving about. * * * Bismuth200 gave immediate and permanent relief. (Dr. G. M. Ockford, Am. Horn., Nov., 1879.)

In a case of poisoning, we evacuate the stomach and then use albuminous and emollient drinks, such as milk. If inflammation has set in, we resort to aconite.