SALICYLIC ACID [Sal-ac]:

-M.L.Tyler.

Introduction:
ONE of the drugs greatly used and sometimes greatly abused by Old School, and therefore worthy of careful study from our point of view. Because, in order to know beforehand and with assurance what a drug can cure, it is necessary to discover just what it can cause of damage to mind and body. So we will endeavour to consider its uses and abuses, in order to gather how best it may be employed. We are told that "it is chiefly used for its effect in articular rheumatism, in which it is highly efficacious, but that it is of no value in gonorrhoeal arthritis or in arthritis deformans, and is of little use in gout". "In acute rheumatism it promptly relieves all the local joint symptoms, but it does not affect the endocarditis, and is in no sense of specific remedy." One can now see why homoeopaths with their host of remedies for rheumatism (or for the patient with rheumatism), are not too ready to bow the knee to any remedy, however popular, which, brilliantly relieving the local condition and the fever, leaves the real menace--to heart-- untouched. One must remember that in children, acute rheumatism is a heart disease, and that anything that suppresses external manifestations with their pains and inconveniences, must be a very dangerous remedy. Acute rheumatism may be easily recovered from, whereas a damaged heart is apt to be a life-sentence and a terrible handicap. By the way, though we are told of its uselessness in gonorrhoeal arthritis, arthritis deformans and gout, yet, given on homoeopathic indications, and in homoeopathic preparation, salicylic acid, like any other drug, has proved its curative powers. The following are its subversive properties, from which we may glean its homoeopathic virtues. Though "analgesic, antipyretic and a feeble antiseptic", it has been used with success, homoeopathically, in puerperal fever. "It irritates mucous membranes and may cause vomiting when given in large doses on an empty stomach. In old school text books, again, we are told that `large therapeutic doses' produce ringing in the ears, nausea, sometimes vomiting, and an increase in the amount of urine ; they may also cause albuminuria and renal irritation, which generally disappear after the drug is excreted. In very large doses it may produce depression of the central nervous system, rarely convulsions is useful in some forms of eye disease. The dose, 15 grains, may be repeated every hour till salicylism occurs, and then three times a day. After death from poisoning by Salicylic acid, ecchymosis and ulceration of the mucous membrane of stomach have been found." Our main experience with Salicylic acid has been in a few cases of Meniere's disease, where it action, in the usual small doses of Homoeopathy, has been prompt and satisfactory. And it has been interesting to see that in some old school text books the drug is recommended for that disease,--because of its power to produce the symptoms!
BLACK LETTER, ITALIC AND SUGGESTIVE SYMPTOMS
ULCERATION OF MUCOUS MEMBRANES. ACUTE ARTICULAR RHEUMATISM. Delirium; stupid ; can hardly collect thoughts; laughed without cause ; talked incessantly and disconnectedly ; frequently looked about him with apparent hallucinations. Vertigo, inclined to fall to left; while surrounding objects seen to fall, to right. MENIERE'S DISEASE; vertigo comes and goes from no cause; headaches frequent, not always present; noises in ear; defective or perosseous hearing; no gastric symptoms, or too slight to account for the rest; indeterminate giddiness in horizontal position, considerable when raising head, or sitting up. Deafness, with noises in ears. Auditory nerve vertigo; troublesome nausea accompanies head symptoms. Incipient catarrh; sneezes all day. Mouth and throat dry; burning and dryness of mouth and fauces. Stomatitis; mouth dry and hot; tongue covered with burning vesicles. Canker sores; with burning soreness and fetid breath. Canker of mouth, stomach and bowels. Burning in throat. Tonsils red, swollen, studded white. Difficulty in swallowing; violent efforts to swallow. Worse right side. Throat and fauces red, swollen, ulcerated. Ecchymoses and ulceration in mucous membrane of stomach and bowels (found P.M. in poisonings). Burning in epigastric region. Dyspepsia; putrid eructations and much gas in stomach. Diarrhoea; cholera infantum, when eructations have a peculiarly putrid and offensive odour. Urine very offensive; with mucus, pus, blood. Urine, 3 hours after passage has a green tinge and deposits a feathery precipitate--salicyluric acid; if these are removed it becomes at once putrid; if not, it remains fresh for above a week. Rheumatism: heat, redness, soreness, swelling about joints, worse knees, with acute piercing pains. Worse motion. Worse touch of anything cold. Worse at night. Better dry heat: hot applications. Copious foul-smelling foot sweats. Sensation as if food wanted to perspire. The pains are burning; also shooting and stitching. Purpura haemorrhagica, with haemorrhages from all mucous membranes; with constant dull aching distress in stomach, and occasional vomiting of blood and mucus. Has a very specific action on serous membranes. DR. HUGHES, Pharmacodynamics: "The physiological effects of the acid and of its compound with soda, we know mainly from observations of over-dosing. Resembles quinine in pathogenetic as well as curative action. Its most striking effects were manifested in a non-contagious fever, which had hitherto been classed separately from the zymoses, I speak of acute rheumatism. As a remedy for this malady it has received the warmest commendation from all quarters. It seems to find its opportunity when the temperature is high, and joint after joint is being involved, with severe pain. Its administration at this time rarely fails to bring down the fever and relieve the pains in the space of 36 to 48 hours. In the face of these facts, we disciples of Hahnemann had to consider what we ought to do. Our results in acute rheumatism, though satisfactory enough, were certainly not so good as those claimed for this remedy." He gives cases in which Salicin in provings and one in enormous dosage in a case of acute rheumatism, provoked fever: in the latter, the temperature rose steadily till death occurred, when the thermometer registered 110 degrees. Also, in experiments on animals, that Salicylic acid, both free and in the state of Salicylate, lowers the temperature, but within restricted limits. In a somewhat larger dose, it not only does not lower the temperature, but sometimes considerably increases it. He says further, that there are three ways in which acute rheumatism has been and can be treated, and the medicines which have been in repute for it fall into three classes accordingly. You may endeavour to neutralize chemically the presumedly acid materies morbi, as by alkalies, neutral salts or lemon juice. You may seek to check the formation of this peccant matter. Or you may forcibly (as it were) repress fever and deaden pain, while leaving untouched the specific morbid process present. The real defect of such remedies is that, leaving the essential malady untouched, and only hushing up its expressions they favour the tendency to relapse, and so unduly protract the illness. He then discusses the symptoms now known as salicylism-- deafness, noises in the ears, vertigo--the essential features of Meniere's disease: "auditory nerve vertigo" for which even old school authorities have found it useful. BOERICKE, Materia Medica, says: "The symptoms point to its use in rheumatism, dyspepsia, and Meniere's disease. Prostration after influenza: also tinnitus aurium and deafness. Haematuria." The Cyclopaedia of Drug Pathogenesy gives interesting cases, especially where it details over-dosage, and poisonings. Their salient features are practically contained in our extracts from Symptomatology, above. Its effects on mucous membranes: its pains, especially burning pains, with inflammation leading to ulceration, foulness and putridity; its specific effects on ears and hearing, with all the symptoms of Meniere's disease: its haemorrhagic tendencies, very pronounced in regard to nose, gums, and stomach, make it an important remedy. In one case a young married woman of 27 was dosed with Salicylic acid for acute rheumatism and developed first the usual deafness, singing in ears and hallucinations of hearing. A few days later, nose and gums began to bleed, and the bleeding from gums became so severe that she grew pale and weak with a small rapid pulse. Large clots collected in mouth, and stools were blackened, it was supposed from swallowed blood. The Salicylic acid was stopped; though the idea was that it might be a purpuric or scorbutic affection:--where upon the haemorrhage also ceased. But when in a few days, for a slight relapse of the articular rheumatism, the salicylate was again given, the very next day, the gums began to bleed again--which finished the treatment by Salicylic acid. It was ascertained that she had never before suffered with bleeding from gums; nor were they spongy or inclined to bleed between these attacks of haemorrhage. In another case, a patient suffering from a very severe and painful attack of acute rheumatic fever, was given large doses of Salicylic acid; after the fifth dose, the pains disappeared by magic; but on the third day he felt all at once a violent pain in epigastric region, and suddenly expired. Quite a number of sudden deaths have been recorded. Besides epistaxis, other haemorrhages had been frequently observed from the administration of large doses of Salicylic acid for acute rheumatism ; among them haematuria, and even retinal haemorrhage. One has an idea that Salicylic acid is used to preserve jams from deterioration. It should--in small doses--since in "heroic" doses it produces, everywhere, putridity. In susceptibles one should look out for even such small salicylic poisonings. One is beginning to think that in our day the devil has special methods of torture and damage for civilized humanity, in the Knowledge of Good and Evil that comes through such sciences as chemistry. The simpler our foods and lives and the more natural, the safer--as regards vigour and well-being. But always the question of individuality and idiosyncrasy creeps in ; and the many seem to tolerate without notable damage what is destruction--perhaps death, to the few. And yet, the many must also suffer, to a less appreciable extent. Moral: the more one learns, the more convinced one is, that the rapid, safe and successful methods of Homoeopathy are preferable, every time, in the treatment--of even such painful conditions as acute rheumatism. Where an indifferent prescriber may not get quick and full results, he, at least, does not endanger life.

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