Toxic effects from the use of bismuth subnitrate in medicine and surgery are so rare that until recently physicians have regarded its administration as perfectly harmless. Schuler1 and Bardeleben2 have pronounced its action non-toxic. The latter treated 100 extensive burns by dusting them with bismuth subnitrate and observed no unpleasant symptoms therefrom. Professor Mühlig3 administered 20 gm. daily for a prolonged period without producing any poisonous effect.
It was, therefore, not surprising that when radiographers began to use bismuth subnitrate for the purpose of obtaining radiographs of the stomach and intestines, they had no hesitancy in administering large doses, and boasted of the safety with which as much as 40 gm. in one dose could be administered.
Cases of poisoning resulting from the administration of bismuth subnitrate have been reported as early as 1793, but these were thought to be due to the impurities in the drug,
BECK EG. TOXIC EFFECTS FROM BISMUTH SUBNITRATE: WITH REPORTS OF CASES TO DATE. JAMA. 1909;LII(1):14–18. doi:10.1001/jama.1909.25420270014001e
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