USES OF BISMUTH SUBNITRATE AND SUBCARBONATE 151 



Bismuthi subnitratis 50.0 gi. 3v. 



Acidi tannici 25.0 3vi. 



lodoformi 15.0 3iv. 



Carbonis ligni 100.0 giii. 3ii. 



M. et fiat pulvis. 



Sig. Dust on surface. 



It may be employed to advantage in coryza and ozena, by insufflation 

 into the nostrils. A paste made by boiling vaseline in an enameled jar 

 and stirring in bismuth subnitrate, in the strength of 33 per cent., is of 

 great value for curing fistulae and chronic suppurating cavities when 

 injected warm so as to completely fill them. If one injection does not 

 cure, repeat in a week and then every 4 days for a month. The paste, 

 while warm, is drawn up into a metal or glass syringe. In small fistuls, 

 as about the rectum, long flexible tips may be used to insert in the sinus. 

 More than 100 grams should not be retained in the body (in the human) 

 lest poisoning occur. 



In old or thick-walled sinuses or abscesses there is little danger of 

 absorption. In thin-walled and recent abscesses a ten per cent, ointment 

 may be used. When there is indigestion and diarrhea with a marked, 

 blue line about the gums, following injection of a large amount of bis- 

 muth, poisoning may occur. 



This is stopped by injecting warm oil into the cavity and aspirating 

 the contents some 12 hours later. 



This method of Beck completely revolutionized the treatment of 

 sinuses, especially those connected with bone. 



Various other suppurating cavities are cured by bismuth injections. 

 Thus empyema, cold and tuberculous abscesses, and sinuses following 

 operations. 



The paste should cause a suppurating sinus to discharge a serous 

 fluid. 



Causes of failure are due to the presence of a foreign body or 

 sequestrum of bone. Or the paste has not been soft enough to enter all 

 pockets. When large amounts of the paste are required substitute chalk 

 for bismuth. Dermatol (bismuth subgallate) is even more eflicient than 

 the subnitrate alone as an antiseptic and astringent dusting powder. 



Internal. — Bismuth is one of the best agents to relieve vomiting in 

 dogs, owing to the soothing and sedative effect upon inflamed mucous 

 membranes. It may be given alone or in combination with oxalate of 

 cerium upon the tongue or in the food. It is also a very efficient agent 

 in diarrhea in the dog, being astringent, sedative and antiseptic. 



Sodii bicarbonatis oii. 



Bismuthi subcarbonatis 3ii. 



Cerii oxalatis 31. 



M. et divide in chartulas No. vi. 



S. Give one powder on tongue every hour. 



Its use should be preceded by the administration of oil or calomel 

 in diarrhea. Bismuth is given for diarrhea in powder with salol; or in 

 suspension with gum arabic and water, with one drop of carbolic acid to 



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