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May 25, 1912

Warning Against Indiscriminate Use of the Bismuth Paste in Acute Suppurations

JAMA. 1912;LVIII(21):1622. doi:10.1001/jama.1912.04260050296026

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To the Editor:  —In The Journal (May 4, p. 1339) Dr. Bell reports very satisfactory results in treating acute and subacute suppurative conditions with bismuth paste. I note that in two of his cases symptoms of bismuth absorption occurred, and while in his cases the progress of the poisoning was checked by proper treatment, others employing this treatment in similar cases might be less fortunate and thus encounter serious complications.I feel prompted, therefore, to issue a warning against the use of the bismuth paste as a substitute for the drainagetube shortly after abdominal operations. In such acute cases our old methods of drainage are entirely satisfactory, and bismuth paste should not be injected unless the suppuration continues for an unusually long period. Under such conditions its injection is permissible, as by that time the adhesions have become sufficiently firm to prevent their rupture through undue pressure caused by the

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