Volume 1

The extra pharmacopœia of Martindale and Westcott.

  • Martindale, William, 1840-1902.
Date:
1924-1925
Catalogue details

Licence: Public Domain Mark

Credit: The extra pharmacopœia of Martindale and Westcott. Source: Wellcome Collection.

    128/1164 (page 84)
    A dose of Sodium Salicylate circulates unchanged in the blood, or in combinations in which its properties are unimpaired. It is rapidly excreted into the bladder, and via the intestines as well as by the sweat, bile and saliva partly unaltered, partly as free salicylic acid and partly in combination.—Pr. March, ’n ; P.J. ii./ii,16. In sciatica the electro-negative salicyl ions may be driven into the tissues.—L. ii./o8,1299, 1314, vide Iontophoresis, Vol. II. Acute rheumatism, large doses, e.g., 150 grains daily, with twice the amount of Sodium Bicarbonate. The latter should always accompany it to render urine alkaline and to prevent constipation. —B.M.J. ii./o8,1812; L. ii./o8,1816 ; B.M.J. i./oc>,147. In rheumatism Stockman has shown that the fall of temperature under treatment with Salicylate and return of joints to the normal, vary within limits with the dose administered.—Pr., Feb. 09,249. Acute rheumatism well treated by recta] injections of 8 Gm. in 150 Cc. with 1*5 Cc. Opium Tincture.—M.P.C. Oct, 1914, p. 371. The CO OH grouping on the Benzene ring in conjunction with the OH in the ortho- position seem to place Salicylic Acid at the highest point of efficacy of all anti-rheumatics ; with 2COOH introduced as in Phthalic Acid efficacy vanishes. The Cresotinic Acids are the only bodies at all approaching Salicylic Acid in utility. It is not known definitely whether the Salicylates act as antitoxins or as antimicrobics. What is wanted is a remedy that will abolish or lessen the chances of injury to the muscles and valves of the heart in treatment of severe rheumatic affections. In acute rheumatism 90 to 160 grains or more in 24 hours act when infection is recent and when the inflammation is confined to joints, but when fibrous tissues of the heart valves or of the muscles or body generally are deeply implicated a more potent remedy is wanted.—R. Stockman, B.M.J. i./i3,598. Salicylates not specific in every form of affection called rheumatic. The pyrexia of acute polyarticular rheumatism was generally controlled within three days, but in the rheumatic state there was often a pyrexia ranging through two degrees, which continued even for weeks and was unaccompanied by any obvious manifestation of rheumatism. Such pyrexia was often un¬ influenced by the Salicylates, though it might yield to Salol or Aspirin. The employment of the Salicylates in rheumatic hyperpyrexia was waste of valuable time. The cutaneous manifestations of rheumatism were uninfluenced. Neither the various forms of erythema purpura nor erythema nodosum ap¬ peared to be influenced and these manifestations had occurred while patients were actually taking the drug. The subcutaneous nodules, described by Barlow and Warner, were undoubtedly rheumatic in nature, but they were quite uninfluenced by the administration of the Salicylates. The similarity of their structure to that of the inflamed valves of the heart in rheumatism was a powerful argument against the utility of the employment of Salicylates in endocarditis or pericarditis. The danger of upsetting the stomach with the irritant Salicylates must be borne in mind in the treatment of all heart affec¬ tions, as also must the risk of acidosis.—B.M.J. i./n,1177 ; L. i./n,1277. The pain of acute rheumatic arthritis should yield in 24 hours with 10 grains and 20 grains of Bicarbonate of Soda every two hours for three doses, and then every four hours.—L. i./n,1277. Pr. Jan. 1912, 91. Rheumatic pericarditis requires large and increasing doses. That this drug is a cardiac depressant and hence to be avoided in pericarditis is a pernicious error. Large doses of this, up to 600 grains daily with 1200 of Sodium Bicar¬ bonate successfully used.—D. B. Lees, P.R.S.M. Med. Sec., Mar. 1910, p. 71. Early cardiac complications of rheumatism, Sodium Salicylate, with Sodium Bicarbonate in the proportion of 1 to 2 most effective—dose to be gradually