328 
DISCOLORATION OF THE SKIN 
ART. LIX. — OBSERVATIONS ON DISCOLORATION OF THE 
SKIN FROM THE INTERNAL USE OF NITRATE OF SIL- 
VER, AND ON THE MEANS OF PREVENTING AND 
REMOVING THAT EFFECT. 
By Charles Patterson, M. D. 
Nitrate of silver is undoubtedly a medicine of great ser- 
vice, especially in the treatment of various spasmodic dis- 
eases, but the danger of producing discoloration of the skin 
by its internal administration, prevents its employment as 
extensively as might otherwise be the case. It must there- 
fore be an object of importance to devise some means of pre- 
venting that untoward effect. 
Dr. Patterson first quotes the opinions of Dr. A. T. Thom- 
son on the subject, who supposes that the nitrate is taken into 
the circulation undecomposed, and, arriving in that state at 
the capillaries of the skin, is there decomposed, and con- 
verted into chloride of silver, which is deposited in the rete 
mucosum. The chloride, he says, acquires a gray leaden co- 
lor from its contact with animal matter; and, as it is insoluble, 
it is incapable of being reabsorbed, is fixed in the rete muco- 
sum, and a permanent stain is given to the skin. Dr. Thom- 
son suggests that, by ordering diluted nitric acid, at the 
time of administering the salt, its decomposition may be 
effected. 
In opposition to these views of Dr. Thomson, Dr. Patterson 
quotes various experiments which he has made, and then 
brings forward his own conclusions, viz. that the chloride of 
silver is not the coloring ingredient on which the blackness 
of the skin depends; but that the discoloration of the skin is 
most probably owing to the decomposition of the chloride of 
silver circulating in the cutaneous tissue through the chemical 
