That there is a prevailing tendency in medicine of late years to minimize the empirical use of drugs, and to rely more largely on intelligent aid to Nature by physical means, cannot be denied. But even the most ardent “therapeutic nihilist” as a rule acknowledges the value of certain drugs at times, and among these the salicylates as a remedy in acute articular rheumatism have occupied a prominent place. Recently, however, Menzer1 has published an article, based on his experiences as a German army surgeon, which contradicts quite forcibly our prevalent conceptions on this subject. He does not dispute the fact that the judicious administration of salicylates may alleviate the symptoms to a marked degree, and so furnish relief to the sufferer and satisfaction to the physician. But in his experience, patients so treated were much more subject to recurrences, and in particular to deforming arthropathies, than were those handled without the use of salicylates. In all, he summarizes the results of his personal observation on 141 patients, of whom eighty-six were given the drug, and fifty-five treated without. Of the former group, eighteen, or 21 per cent., were incapacitated for further military service, and of the latter, four, or only 7 per cent. On the other hand, severe cardiac complications were about half again as frequent in the absence of salicylate treatment, pleuritis was almost four times as frequent, and the average length of treatment was increased from forty-six to seventy-four days. In addition to his own figures, Menzer cites those of several others, notably of Badt2 (324 cases), which support to some extent his position.
SALICYLATES IN ACUTE ARTICULAR RHEUMATISM. JAMA. 2011;305(24):2583. doi:10.1001/jama.2011.818