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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    third day from that time an acute pneumonia of the right lung, pericarditis, and pleurisy on the left side made their appear- ance. Twelve hours after these complications were discovered the temperature was still 98’6°, and in twelve hours more the girl died with her temperature below 100°, but with a pustular miliary eruption, pericarditis, left pleurisy, and consolidation of a large part of the right lung. When the treatment is commenced before any secondary affections have made their appearance, the probabilities of their doing so are, of course, very greatly diminished, but they are not even under such circumstances necessarily prevented, for both cardiac and pulmonary diseases have arisen in several cases while the system was saturated with salicylate of soda. The question of the production of albuminuria by the salicylate is one which has received some attention, and it has even been suggested that the delirium may be due to this cause. There is no doubt that occasionally albumen makes its appear- ance in the urine after the treatment has been commenced; but the facts—that in the great majority of cases it does not do so; that in many cases in which albumen is present before the drug is given it disappears during its administration; and, finally, that albumen is frequently present in the urine of rheumatic patients with high temperature before any treat- ment whatever has been applied, go far to prove that the albuminuria ordinarily has nothing to do with the medicine. It is only recently that I have been carefully observing the occurrence of albuminuria in cases of rheumatic fever with a view to determine how far it is a result of the treatment by salicylate of soda. Out of ten cases in which albumen was present, seven had it before the drug was administered, and it disappeared in all these while the urine still gave a strong reaction with the perchloride of iron. In the eighth case the urine was not tested for albumen before the medicine was given, but albumen was found in it and disappeared from it while it still contained the salicylate. In the remaining two cases the urine contained no albumen before the treatment was commenced, but it made its appearance afterwards, and again disappeared while the urine still contained the drug. At any rate it can be stated with certainty that salicylate of soda, when given in the ordinary doses, never produces perma-