A large number of bismuth compounds have been proposed for medicinal use in the last few years. The following may be mentioned as examples: Airol (bismuth oxyiodosubgallate), bismal (bismuth methylene digallate), bismutol ("bismuth sodium phosphate salicylate "), crurin (quinolin bismuth sulphocyanate), iodogalli-cin (bismuth oxyiodide methyl-gallol), other phenolates, the benzoate, the cinnamy-late (hetoform), the cresolate, the lactate, the bilactomonotannate (lactanines), the phenolsulphonate, the tannate, and similar salts; also proteid compounds, as the pep-tonate; compounds with resorcin, pyrogallol (helcosol), etc.

Bismuth Naphtholate. - Dose, 15-30 grains (1.0-2.0 Gm.).

Bismuth Tribromphenate. - Dose, 60-75 grains (4.0-5.0 Gm.).

Dermol (Bismuth Chrysophanate). - Description and Properties. - An amorphous yellow powder, neutral in reaction, insoluble in water or alcohol. Used externally and locally.

Thioform. - A combination of bismuth, sulphur, and salicylic acid.

Description and Properties. - A light, grayish-yellow powder, odorless and tasteless, insoluble in water, alcohol, or ether. Used externally and locally.

Xeroform. - Tribromphenolate of bismuth, containing 50 per cent. of Bi2O3. It is a yellow, neutral, insoluble powder, tasteless, odorless, and non-irritating. It is used in doses of 8-15 grains (0.5-1.0Gm.) as an intestinal antiseptic. It is useful in fresh wounds, in gynecology, and in eczemas and prurigo.

Orphal. - Beta-naphthol bismuth, containing 7 per cent. of oxide of bismuth and 23 per cent. of beta-naphthol. It is a light-brown powder of pleasant taste, and splits up in the intestines into bismuth and beta-naphthol. It is used as an intestinal antiseptic in doses of 8-45 grains (0.5-3.0 Gm.).

Eudoxin. - This is a bismuth salt of nosophan (a. v.). It is used in the same way as xeroform.

There is a long list of other bismuth combinations, some of which may be found, after further observation, to be of service.

Antagonists and Incompatibles. - The salts of bismuth are insoluble, and should not be prescribed with other agents in solution.

Synergists. - The sedative action of bismuth upon the stomach may be increased by calomel and cerium oxalate, and pepsin may be given as a substitute for this purpose. The astringency of the bismuth salts may be enhanced by the addition of opium and tannic acid.

Physiological Action. - Externally. - Bismuth salts are mildly astringent, but have no appreciable physiological effect upon the unbroken skin.

Internally. - Digestive System. - Bismuth is insoluble in the gastro-intestinal juices. It coats the mucous membrane, lessening secretions and absorbing excess of free acids, at the same time acting as a sedative and feeble astringent. The tongue and stools are tinged a dark-clay color, due to conversion into the sulphide. The soluble salts are absorbed very slowly, and increase the appetite and digestion, constipation being the result.

In its general action bismuth is of interest only experimentally. In mammals intravenous injections of soluble salts cause slowing of the heart action, acceleration of the respiration, and irritative phenomena of the nervous system (convulsions).

Absorption and Elimination. - The salts of bismuth are absorbed into the circulation, and are eliminated by the urine, liver, and feces.

Untoward Action. - Odier noticed nausea, and Weenesk vomiting, colicky pains, diarrhea, or constipation, headache, sensation of heat, dizziness, and general debility.

Poisoning. - It has always been assumed that cases of poisoning are due to the lead and arsenic contained in the bismuth preparations, and few cases of poisoning are known from the internal use of bismuth. Local applications (dermatol) have given rise to gastro-intestinal irritation - salivation, sore gums, sloughing in the palate, etc. These symptoms disappear on removing the dressings.

Therapeutics. - Externally and Locally. - Bismuth subnitrate is serviceable in intertrigo, erythema, acne rosacea, as a protective dressing for wounds, ulcers, and epithelioma, and as an application for chapped nipples and hands, relieving the smarting and itching. It is also of use in fissure, prolapsus ani, and superficial burns.

It is used as an injection in gonorrhea, leukorrhea, and ozena, and was formerly used as an insufflation in acute nasal catarrh, being abandoned because of the arsenic which it sometimes contains. It serves as a wash in aphthous stomatitis, mild cases of mercurial salivation, and cancrum oris, as well as for the fetid sweating of feet and other parts, and for chancres and phlegmonous erysipelas. It has also proved beneficial in chronic conjunctivitis and granular lids or trachoma.

Internally. - It allays irritation, and is consequently useful in irritative vomiting and diarrhea. Gastric pain is relieved by it. It is valuable in pyrosis, chronic diarrhea, gastric ulcer, chronic dysentery, diarrhea of typhoid, early stages of cholera and cholera infantum, and in the gastritis due to alcohol.

The citrate of bismuth and ammonium is very soluble, and should be used only for local applications.

The oxide is insoluble, and combined with morphine has been used as a snuff in ozena and nasal catarrh.

Subcarbonate of bismuth is frequently used as an intestinal antiseptic.

Subsalicylate of bismuth reduces the pulse and temperature in typhoid fever, and also corrects fetid stools of indigestion diarrheas.

Bismuth subgallate, or dermatol, was first used by Heintz and Liebreich, being intended as a substitute for iodoform; but it is very astringent, although not irritating. The preparation is used in weeping eczema, otitis media, herpes, wounds, burns, diarrhea, and dysentery. In stagnant ulcers it is of no service, since they need stimulation.

Bismuth citrate is insoluble, and is of no service medicinally.

Besides the foregoing preparations there is a tannate of bismuth, used to some extent in diarrhea, gonorrhea, leukorrhea, and ophthalmia.

Phosphate of bismuth is the least soluble of all the bismuth compounds, and is used, but rarely, in diarrhea, dysentery, gastral-gia, and dyspepsia.

Subiodide of bismuth is used as a substitute for the subnitrate, and is of special value in chronic ulcers. It is supposed to be slightly anesthetic.

Subbenzoate of bismuth is mildly escharotic.

Administration. - The drug is used externally as a powder or ointment in combination with naphthalin or vaseline, to which a little morphine may be added. Belladonna, opium, and oleate of bismuth are also used.

For gastralgia and dyspepsia, pepsin or magnesium and calcium phosphate may be combined with bismuth. If a cathartic is desirable, rhubarb may be added.

Bismuth, aromatic powder, and carbo ligni make an excellent combination in flatulent dyspepsia.

In infantile diarrhea and summer complaint bismuth 1 grain (0.06 Gm.), syrupus aurantii 15 minims (0.92 Cc), and calumba 15 minims (0.92 Cc.) are efficacious, particularly as they allay the alternating pain. Large quantities of bismuth are advisable.

Bismuth, 5-15 grains (0.32-1.0 Gm.), is given for stomach affections, and 15 grains (1.0 Gm.) to 1 dram (4.0 Gm.) for intestinal disorders, one to two hours after meals as the stomach is emptied.