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Philadelphia, Nov. 26, 1901.
To the Editor:
—I was greatly interested in the Editorial entitled "Intoxication with Bismuth," published in the issue of The Journal for November 23. I have long been aware of the fact that bismuth applied to sore surfaces may exert a toxic and even a fatal effect. Several years ago there was a patient in the Woman's Hospital here with an extensive burn of one arm, over which bismuth subnitrate had been thickly dusted. The powder had united with the secretions of the ulcerated surface and formed a thick "cast" like that of plaster of Paris. The patient developed acute stomatitis characterized by great pain, tenderness and swelling, and broad bluish lines along the edges of the teeth and the inner borders of the lips. I have no record of the case, and can only state that the patient fell into a state of profound asthenia
Henry FP. Bismuth Poisoning.. JAMA. 1901;XXXVII(23):1544. doi:10.1001/jama.1901.02470490042014