402  Salicylic  Acid  and  Sodium  Salicylate.    { September, hiam- 
covery  of  a  new  agent  for  the  treatment  of  rheumatism  that  was 
called  salicylic  acid.  It  was  being  reported  by  German  physicians 
that  it  was  an  agent  with  remarkable  and  undoubted  power  to  relieve 
the  symptoms  of  acute  articular  rheumatism.  After  considerable 
time  and  effort,  he  succeeded  in  securing  a  quantity  and  prescribing 
it,  certainly  for  the  first  time  in  any  of  the  public  hospitals  of 
Chicago,  and  the  first  time  in  his  own  practice.  The  effect  was 
wonderful.  In  three  days  patients  who  previously  would  lie  weeks 
and  weeks  in  a  state  of  perspiration  and  suffering,  requiring  Dover's 
powders  at  night,  were  sufficiently  relieved  from  pain  to  sleep. 
Opiates  were  withdrawn  entirely.  Under  the  influence  of  this 
remedy,  in  three  days'  time  these  patients  would  be  out  of  bed, 
walking  around,  asking  to  be  allowed  to  return  home.  But  in  a  few 
days  he  found  that  the  patients  thus  cured,  who  went  home,  were 
brought  back  to  the  hospital  again.  Physicians  had  not  yet  learned 
that  it  is  necessary  to  continue  treatment,  even  after  the  relief  of  the 
pain  and  disappearance  of  the  swelling  that  affected  the  joints,  one 
of  the  facts  which  goes  to  prove  that  the  disease  does  not  consist 
merely  of  a  painful  swelling ;  it  is  a  disorganization  of  the  joints  of 
a  more  serious  nature  than  mere  local  tenderness,  and  it  is  very 
essential  to  continue  the  administration  of  salicylic  acid  for  two  or 
three  weeks  after  the  relief  of  the  pain.  It  was  not  long  before  it 
was  learned  by  experimentation  that  the  salts  of  salicylic  acid  were 
even  better  and  a  more  convenient  means  of  medication  than  the 
salicylic  acid  itself.  Then  it  was  not  long  before  it  was  found  that 
patients  did  not  do  as  well  with  the  salicylates  prepared  in  this 
country  as  they  did  with  those  prepared  in  Germany.  For  a  con- 
siderable time  disagreeable  results  followed  the  use  of  sodium  salicy- 
late prepared  in  America.  It  was  impure ;  it  deteriorated  with 
keeping ;  it  did  not  produce  the  effects  that  were  secured  from  the 
original  German  article. 
One  day  he  was  called  to  see  a  young  man  suffering  from  acute 
articular  rheumatism,  and  prescribed  sodium  salicylate.  The  patient 
took  it  according  to  direction,  and  having  taken  it  for  three  days, 
he  went  to  the  house  on  the  morning  of  the  third  day  of  his  illness, 
was  met  by  the  mother  with  an  expression  of  horror,  who  said:  "I 
was  not  aware  that  my  son  was  such  a  boy  ;  that  he  ever  touched 
liquor  of  any  kind  ;  he  has  got  delirium  tremens  ;  "  and,  in  fact,  he 
presented  the  symptoms.    There  were  delirium,  picking  of  the 
