Bismuth toxemia, fortunately, is now rare. Five years ago one of us (A. E. O.) prepared an alkaline solution of bismuth and potassium tartrate1 for use as a cytographic medium and found it roentgenologically satisfactory in more than one hundred cases and without toxic effect.2 Subsequently, after the use of this substance prepared elsewhere, we observed two patients with acute bismuth toxemia, and we are reporting these cases because the symptoms and course were unusual.
The chief initial symptom was oliguria or anuria, and it was not until characteristic stomatitis developed later that bismuth toxemia was suspected. Experimental studies on animals have demonstrated that toxic amounts of bismuth salts will cause a disturbance in renal function,3 including azotemia and a renal lesion most noticeable in the tubular cells.4 A fatal case in which there was anuria with marked retention of urea in the blood was reported
KEITH NM, OSTERBERG AE. ACUTE BISMUTH POISONING, WITH RECOVERY. Arch Intern Med (Chic). 1937;60(3):415-423. doi:10.1001/archinte.1937.00180030032002