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November 23, 1901


JAMA. 1901;XXXVII(21):1395. doi:10.1001/jama.1901.02470470037008

The general impression prevails that when symptoms of poisoning arise in connection with the administration of bismuth or its combinations the manifestations are due to the presence of impurities, the most important of which is thought to be arsenic. Evidence is not wanting, however, tending to show that uncontaminated bismuth may give rise to toxic effects, which in some respects resemble those due to lead and mercury. A number of such instances are cited in a brief communication by Dr. Dreesmann,1 who also reports a case under his own observation. Thus, following the dressing of wounds and wound cavities with bismuth subnitrate and other preparations of bismuth, as well as the internal administration of large amounts, there has been observed in the urine a white precipitate, becoming black, together with albumin and tube casts, stomatitis, pain in and loosening of the teeth, a metallic taste, with a blue line