In 1912, when Mayer and Baehr1 reviewed the literature of bismuth intoxication following the local application of bismuth to granulating surfaces, they collected reports of sixty-four cases of poisoning with twenty-four fatalities. Since that time there have been four cases of bismuth poisoning reported with two deaths.
The fact that there have been so few cases reported in the last few years, although the bismuth treatment has been used extensively, may indicate that, with improved technic and greater care in its use, the occurrence of this complication has become rare, or else instances of mild intoxication have not been recognized.
Dr. Beck2 says, "The occurrence of this accident has deterred many surgeons from employing the bismuth treatment, and since poisoning can be avoided, it would be deplorable that an otherwise useful method should not be employed on this account." That toxic results cannot be entirely avoided is shown
FREILICH EB. BISMUTH POISONING FOLLOWING BISMUTH PASTE INJECTION. JAMA. 1917;LXVIII(2):111. doi:10.1001/jama.1917.04270010111011