Salicylate therapy has been in use for over half a century for the treatment of acute rheumatic fever, and opinions have varied among clinicians as to the mode of action and the value of the salicyl compounds. Although most authorities have agreed that these drugs exert definite antipyretic and analgesic actions, few have maintained that salicylates actually modify the course of the disease. Tremendous interest has been aroused, therefore, by Coburn's recent report1 that massive doses of sodium salicylate produce a prompt subsidence of rheumatic inflammation if a level of blood salicyl (measured as salicylic acid) above 350 micrograms per cubic centimeter is maintained. To maintain such a level, Coburn advocated the daily administration of from 10 to 20 Gm. of the drug. This amount exceeds the toxic and even the fatal dose as given in some textbooks of pharmacology.2
Numerous reports of salicylate poisoning in children have