SALICYLIC ACID: 
THE EXPERIENCE OP MAINE PHYSI- 
CIANS IN ITS USE. 
REPORTED liY 
FREDERIC HENRY GERRISII, M.D., 
of Portland. 
(Reprinted from tlie Transactions of the Maine Medical Association, 
June, 1870.) 
PORTLAND, ME.: 
STEPHEN BERRY, PRINTER. 
1876. SALICYLIC ACID: 
THE EXPERIENCE OF MAINE PHYSI- 
CIANS IN ITS USE. 
REPORTED BY X 
iy 
FREDERIC IIENRY GERRISH, M.D., 
of Portland. 
(Reprinted from the Transactions of the Maine Medical Association, 
June, 1870.) 
PORTLAND, ME.: 
STEPHEN BERRY, PRINTER. 
1876. REPORT. 
At the last meeting of the Association, I was appointed to 
report this year on New Remedies. As it would, for various 
reasons, be extremely undesirable to include accounts of all the 
new remedial agents which have recently attracted attention, I 
decided to limit my paper to a consideration of the two which 
seem to have been most carefully investigated and promise most 
for the future—Salicylic Acid and Jaborandi. Doubtless a digest 
of the best articles on these subjects which have appeared in the 
journals would be of some interest; but, believing that the essay 
would have a peculiar value to the Association and the profes- 
sion generally if it could epitomize the experience of all members 
who had made any trial of these drugs (especially as nothing 
about them had yet been published by Maine men), I sent to 
each member of our Association, early in May, a circular from 
which I quote the following lines: 
“I want to ascertain if you have used either or both of these 
agents in any way; if so, to what extent, in what manner and 
what doses, for what diseases, with what results, what combina- 
tions with other medicines are desirable, what precautions should 
be observed in administration, what experiments with regard to 
their physiological action you have performed or witnessed, and 
any other facts and opinions resulting from your personal observa- 
tion of these drugs which you may be able to contribute. 
“Although a compliance with this request may necessitate a 
considerable expenditure of your valuable time, I trust you will 4 
not consider it poorly bestowed; for only by means of such 
reports from physicians can the proper therapeutical position of 
these remedies be determined, and the more speedily this is done 
the better will it be for our patients and ourselves.” 
Two hundred and fifty of the circulars were sent out, and 
thirty answers have been received. Of this number only seven- 
teen came from physicians who had used either of the drugs, the 
remainder being simply acknowledgments of the circular. It is, 
of course, incredible that these are nearly all of our members who 
have employed either of the agents named ; and the small num- 
ber of replies may fairly be attributed in great part to the indis- 
position of medical men to report their experience—a trait which 
is equally proverbial and unfortunate. 
Only three—Drs. A. J. Fuller, of Bath, Laughton, of Bangor, 
and Chase, of Orland—have used jaborandi; and their observa- 
tions have been so limited, and their results, on the whole, so 
indefinite, that a publication of them would afford almost no sat- 
isfaction. My paper will, therefore, be confined to a considera- 
tion of the therapeutical experience of sixteen Maine physicians 
with salicylic acid. 
INTERNAL USES. 
Acute Rheumatism. Dr. Pendleton, of Belfast, writes as 
follows: 
“ In the treatment of rlieuinatic fever, I liave usually relied on 
the alkalies, nitrate, acetate and bicarbonate of potassium, with 
such other remedies as each case might indicate for itself, and 
have no fault to find with the success of these medicines. Yet 
I believe that the acid will often break up or shorten the fever. 
Two years ago I attended a young man through twenty days of 
acute rheumatism. Two other members of the family had had 
such attacks. I gave him alkalies, quinia, Dover’s powder, lemon 
juice, etc.; good recovery. 
“ The first Sunday of January, this year, I was called to him, and 
found apparently just such a disease upon him. His skin was 
hot, pulse 108, pain intense in right hip and both ankles, the 
latter swollen and tender. I dressed the joints in cotton, and 5 
gave him 10 grains salicylic acid ; this was at one o’clock p. m. ; 
ordered same dose to be repeated every two hours. At ten in 
the evening, his pain was so great, I was called again, and under 
other circumstances should have given an opiate, but ordered the 
above dose of acid to be given every hour. Before morning he 
slept quietly, and no more medicine was taken until five p. m. 
Monday, when the pain returned. The acid was renewed, with 
excellent effect. Pulse came down, pain subsided, swelling 
abated, and there was no occasion for my visits after the middle 
of the week. I attributed all to the acid, and believe it saved 
him another twenty days’ seige. 
“In some other cases it has seemed to act as well, but I was 
not so sure of the disease; that is, the remedy was given and 
relief obtained before I could be sure that a rheumatic fever 
would have certainly followed, so I refrain from detail. I have 
never seen any nausea or dizziness from the doses I have named.” 
Dr, Shannon, of Cape Elizabeth, reports one case: 
“Mr. ])., aged 75, feeble and asthenic, was attacked with 
acute rheumatism. I began to treat him February 14th. At 
that time his feet, knees, shoulders, elbows and hands were 
swollen and very painful. I treated him with the usual remedies 
for rheumatism for a few days, with little or no improvement. 
I then gave him grains salicylic acid (in wafers) every hour for 
twenty-four hours. 11 is symptoms were so much improved that 
the acid was suspended ; but, before the end of twenty-four hours 
more, all the rheumatic symptoms re-appeared with their former 
violence. I again gave the salicylic acid, from 7£ to 10 grains 
every hour for ten or twelve hours, when the pain began to sub- 
side, after which we gave it every two or three hours, according 
to pain, continuing until the patient had taken 75 wafers, with 
7£ grains of acid in each (over nine drachms). lie had no more 
acute symptoms.” 
Dr. Dana, of Portland, says, “I shall not be able to give you 
the details of my cases, but rather general results and the im- 
pressions made upon my mind in watching the effects of the 
drug,” this statement applying to his remarks on all the diseases of which lie makes mention in this paper, lie has used the acid 
in a dozen cases of rheumatic fever, meeting with favorable 
results in every case, excepting two. “ In one of these, the 
patient, a young man, was unable to swallow the medicine, while 
in the other, a lady found the effect upon the stomach so disa- 
greeable that its use was omitted. The effect was most marked 
upon the pain, which was usually considerably relieved within 
the first thirty-six hours, the redness and swelling of the joints 
often beginning to subside in the same period of time, the patient 
being able to walk, without suffering, in a few days more. I had 
a number of cases of rheumatic fever, which, under the alkaline 
treatment, I judged likely to last two or three weeks, which 
were over in five days, and no relapse, under use of the salicylic 
acid. One man, whom I had seen in his bed with knees and 
wrists and shoulders swollen and painful to an intense degree, I 
met, while on my way down to his house on the sixth day, 
walking up to my office. 
“I am inclined to look upon it as the most effective drug 
known for the cure of rheumatism.” 
Dr. Price, of Bath, was called to treat a sailor who had been 
suffering four days with acute rheumatism. The case was well 
marked in every respect. Large doses of alkalies, quinia and 
opiates were given, and anodynes were applied to the joints, 
which were covered with batting; but after eleven days the 
symptoms had been but little relieved. 
On the 9th of April, the doctor ordered ten grains of the acid 
to be given every hour while the patient was awake, and all other 
medication to be discontinued. The patient passed a comforta- 
ble night. The next morning the joints were less painful and 
the temperature was reduced. Acid continued in same dose 
every two hours. 
12th of April, marked improvement; acid continued every three 
hours in five grain doses. 
On the 13th, the patient felt so well that he over-exerted and 
exposed himself, producing a partial relapse; but a renewal of 
the large doses of the acid speedily restored him, and on the 17th 
the necessity for medication ceased. 7 
Dr. W. S. ITill, of Augusta, writes that, “ in a case of acute 
rheumatism, where the pain in the joints was very severe, and 
the heart’s action was beginning to be irregular, two (loses, of eight 
grains each, were administered, two hours intervening between 
the doses. The result was considerable diminution of the pain 
and soreness in the joints after the first dose, and entire relief 
after the second. Twelve hours later the heart’s action was reg- 
ular and normal in all respects, and the patient had no further 
trouble. My partner, Dr. C. JK. Norton, had a like experience in 
a case seen by him and treated in the same manner.” 
Dr. Everleth, of Waldoboro, reports the following: 
“ I have used it in three cases of acute rheumatism, arresting 
the disease and relieving the suffering much quicker than I have 
been able to do heretofore by use of any other remedies. 
“ The first case was that of the bass singer accompanying the 
Hyer troupe on their concert tour through this section last 
winter. He had been suffering two days, and I found the great 
toe and first metatarsal joint swollen, red and extremely painful, 
so that he was unable to sit up. I gave an opiate, and ordered 
the part packed in an alkaline lotion. In about four hours I was 
called again, the suffering having returned as severely as ever. 
Gave salicylic acid, about eight grains, every three hours,, in 
syrup. Next day found him suffering less, having slept some; 
continued acid every four hours. Next day (forty-eight hours) 
he was able to resume his journey, and sang the same night in 
Rockland. 
“ In another case, a lady was affected with rheumatic inflam- 
mation of the left hand and wrist joint; had been suffering two 
days. Gave salicylic acid, about eight grains, every three hours, 
in molasses. Next day pain and swelling very much reduced; 
able to move the hand. Continued acid less frequently, and in 
three days suspended it altogether, the woman thinking herself 
well and using the hand. 
“ The other was a case of rheumatic inflammation of the knee 
in a lady. Treatment the same, with the same results. Nothing 
else was given, only as stated above, and no unpleasant results 
were observed to follow the use of the acid.” 8 
Dr. Laughton, of Bangor, lias found that, in doses of from ten 
to fifteen grains every third hour, tlie acid lias allayed the in- 
flammation and relieved the pain in from twenty to thirty hours. 
In the dozen cases in which he has used it, there have never 
been any ill effects, but always relief. 
Chronic Articular Rheumatism. Dr. Dana has treated eight 
cases with the acid. “I will mention one, the most favorable ex- 
ample. A gentleman had his left knee swollen and painful, 
especially at night, and troubling him about standing or walking 
much. The synovial fluid was in marked excess, and he limped. 
The case was of many months’ standing. I gave him two drachms 
daily, for two days, when he reported himself better in general 
feeling, and especially in condition of knee, but he ‘felt as if he 
had a first-class brass-foundry in his head.’ On reducing to one 
drachm a day, the roaring in head abated, and the use, with occa- 
sional intermissions, of two or three scruples a day for several 
weeks, was attended not only with a great improvement in the 
knee, which has been nearly well now for two or three months, but 
also in an improved tone of his general health. It has not, how- 
ever, proved by any means so useful in this class as in the class of 
acute cases.” 
/Sub-acute Rheumatism. Dr. Thayer, of Portland, writes: 
“I have used the acid in several cases of sub-acute rheumatism, 
and have been very much pleased with its action. Have admin- 
istered it in wafers, in doses of from seven to ten grains every 
two hours, until it affected the organs of hearing, then decreasing 
the frequency of the dose from two hours to four or six hours. 
The pain and soreness of the joints have almost invariably been 
relieved as soon as the system has been brought under its influ- 
ence. 
Rheumatic Neuralgia. Dr. Dana has tried the acid in a dozen 
or fifteen cases, and says, “ I have been pleased with its effects. 
Shifting muscular and darting pains along the tract of nerves 
have repeatedly yielded to its use. In two cases of paralysis, 
one general, the other hemiplegic, in which erratic, but very dis- 
tressing pains paroxysmally occurred, I found more relief from 
the use of this than of any other drug.” 9 
Lumbago and Sciatica. Dr. T. A. Foster, of Portland, con- 
tributes the following: 
“ The case in which I used salicylic acid was that of a lady 
between fifty and sixty years of age, who had been rather feeble 
for some months. Fora week or more before I was called to see 
her, she had been suffering from lumbago and sciatica. The tract 
of the left sciatic nerve was very tender, and the pain most in- 
tense from back to foot. I gave her seven grain doses of the 
acid in wafers, every two hours, until she had taken two drachms, 
then every four hours, until she had taken as much more, using 
for immediate relief hypodermic injection of morphia night and 
morning. I could not perceive that the acid produced any effect, 
unless it caused a disagreeable feeling at the pit of the stomach. 
I consequently left it off and gave quinine and iron instead, 
which, with my hypodermic injection continued for some ten 
days, relieved the patient from pain and lameness in about three 
weeks.” 
Diphtheria. Dr. Weeks, of Portland, reports that, during the 
epidemic of this disease which prevailed in this city and vicinity 
in the winter of 1875-6, he used the acid internally, and also as a 
local application in a few cases, without any apparently beneficial 
effects. 
Chronic Diarrhoea. Dr. Price reports one case. “Patient, 
aged 39, has passed continually since August, 1875, bloody, 
slimy, dark and tenacious stools, with pain, some days having as 
many as five evacuations. Dr. Bibber and myself have treated 
him most of the time, and had nearly exhausted the materia 
medica without benefit, when it occurred to me to test the merits 
of salicylic acid in intestinal disease. I prescribed it in five 
grain doses every four hours while awake, discontinuing all other 
treatment. Patient has now taken the acid about twelve days; 
says he has not felt so well for a year; has only one stool a day, 
and no pain, blood or mucus.” 
Periostitis. Dr. Laughton, having had satisfactory results 
from the use of the acid in rheumatic fever, was led to test its 
power as an antiphlogistic in a case of periosteal inflammation of 10 
the fibula. Large doses, frequently repeated, “ exerted a remark- 
able influence in arresting inflammation of the tissues covering 
the diseased locality.” 
LOCAL USES. 
Gangrene. Dr. Pendleton writes : 
“ I have recently had under iny care a ragged wound, pro- 
duced by the discharge of some thirty buck-shot into the soft 
part of the leg inside the tibia. The boy was healthy, the bone 
apparently not injured, the wound was trimmed and dressed 
promptly, not neglected subsequently, and yet it would not heal, 
but persisted in sloughing, until I applied salicylic acid, mixed 
with starch (about half and half), dusting the mixture over the 
surface after washing it. The effect was all that could be desired. 
The discharge became healthy, granulations formed, and the new 
cuticle is now rapidly spreading from the edges.” 
Dr. Holt, Surgical House Pupil at the Maine General Hospital, 
reports that the acid “ has been used quite freely and success- 
fully as a disinfectant at the hospital. I will cite three cases 
where it was found far superior to other drugs. J. A. M., aged 
seventy-six, entered the hospital with an erysipelatous inflam- 
mation of the ankle and foot, resulting in extensive sloughing of 
the leg and destruction of the ankle joint. The discharge was 
profuse, ichorous in character, and very offensive. Under the 
use of salicylic acid solution the odor disappeared, and the dis- 
charge was very much lessened. 
“J. 13. W., aged fifty-four, entered the hospital with an ex- 
tensive bed-sore over the sacrum and coccyx. The application of 
a solution of salicylic acid destroyed the odor, cleansed the 
wound and reduced the discharge rapidly. In this case it is 
thought it prevented granulations, for this reason : as long as it 
was used there was no attempt at granulation, but as soon as 
carbolic acid was substituted granulations sprung up at once. 
However, the odor reappeared to such an extent that the sali- 
cylic acid was considered far superior as a disinfectant. Un- 
fortunately, the patient left before the salicylic acid could be 
tried again. 11 
“ T. I?., aged fifty, entered the hospital last January, with com- 
plete luxation of the spinal column between the eleventh and 
twelfth dorsal vertebrae. He was obliged to lie upon his back 
for a long time. lie was transferred to a water-bed, but, in spite 
of all precaution, extensive bed-sores formed on the sacrum, side 
of the legs, over the fibula, heels and external malleoli. About 
the first of March, septic matter was absorbed to such an extent 
that he had chills, profuse sweats, head-ache, vertigo, etc. The 
sores were discharging profusely in spite of treatment, and the 
odor was almost unbearable. He was fast losing flesh and 
strength, and all looked forward to a speedy dissolution. A solu- 
tion of salicylic acid was applied, and immediately the odor dis- 
appeared, the discharge subsided and be rapidly began to rally. 
TIis appetite came back, and he gained flesh and strength so 
rapidly that he did not appear like the same person in two weeks. 
Carbolic acid and chloral hydrate, chlorinated soda, etc., have 
been used in this same case, and were found far inferior. 
“In regard to the salicylic acid preventing granulations in this 
case, it might be said that the change of disinfectants made but 
little difference to the granulations, for they have always been 
below par, owing to the fact they are seated below the point of 
injury, where sensation and motion have been entirely suspended 
since the accident. 
“Whenever a saturated aqueous solution did not seem strong 
enough, borate of sodium was used to facilitate the solution of a 
larger quantity of the acid. The solution was applied usually by 
means of cloths saturated with it, sometimes by the atomizer.” 
Diphtheria. I)r. Small, of Portland, has made use of the acid 
in several cases. In the mild form, no benefit was noticed; but 
he is confident that he “ did see good results from its use where 
the false membrane had been formed two or three days and had 
undergone those changes which impart to the breath its peculiarly 
offensive odor, and give to the fauces the appearance of being 
the seat of a sloughing ulcer.” The fetor was controlled and 
granulation promoted. It should be borne in mind, however, 
that iron was given internally in all these cases, and in some of 
them salicylic acid, also. 12 
Dr. Thayer reports as follows : 
“I have used a solution varying in strength from five to twelve 
grains to the ounce, combined with au equal amount of borate of 
sodium, in order to have the acid completely dissolved. By 
means of a camel’s-hair brush, I have had this solution applied 
freely over the tonsils and fauces every two or three hours in 
some cases; in others, instead of using the brush, I have made 
use of the spray, by means of the steam atomizer. Am unable 
to say that I have ever derived any benefit in a single case from 
its use, other than in destroying the fetid odor of the breath.” 
Dr. A. J. Fuller, of Bath, has employed it as a substitute for 
the antiseptic carbolic applications in diphtheritic and many other 
cases; but is not yet prepared to relinquish the carbolic acid 
altogether, although there is an undoubted advantage in the 
•salicylic .acid in its freedom from odor. 
Pharyngitis. Dr. Price has of late prescribed the acid “almost 
to the exclusion of other medicines, as a local application to the 
ulcerated throats of scarlet fever, and with good results, some- 
times using the powder alone, blown through a tube direct upon 
the parts. When children are old enough to gargle, I often use 
a solution as a wash.” 
Dr. Bibber, of Bath, has likewise used the acid extensively in 
cases of this kind, with the happiest results. Tie mentions a 
severe case of scarlatina anginosa, in which “ the tonsils, soft 
palate and pharynx were covered with false membrane so thickly 
that it was impossible for the child to swallow, drink and food 
being thrown out through the nostrils.” Three local applications 
of a solution of the acid were followed by the loosening and dis- 
charge of the membrane. 
Dr. Harlow, of Augusta, has noticed good results from the 
use of the acid as a gargle in inflammatory sore throat. 
Ulcers of Os Uteri. Dr. Pendleton says: 
“I first used it as a local application to the ulcerated os uteri, 
in the form of powder, and though it is far from displacing, in 
iny estimation, any of the old remedies, yet, when the ulceration 13 
was superficial and the discharge thin, sanious and fetid, like 
that from a gangrenous sore, I found it would clean the abrasions 
admirably and heal them quicker than other applications upon 
which we usually rely.” 
Dr. Snow, of Winthrop, reports a similar experience, and also 
esteems the acid in the treatment of chronic ulcers in other situ- 
ations. 
Otorrhoea. Dr. Laughton has used the acid in solution, with 
good effect in this affection. 
Gonorrhoea. Dr. Thayer, of Portland, has employed this 
remedy to a limited extent in urethritis, “ and, from the favorable 
results thus far obtained, is inclined to continue its use still 
further as opportunity offers.” Dr. Laughton has likewise made 
use of it, but has not had as satisfactory results as in otorrhoea. 
Conjunctivitis. Dr. A. J. Fuller has found the acid a reliable 
remedy when used in weak aqueous solution. 
Pruritus of Skin Diseases. Dr. Snow has had excellent re- 
sults from the use of a solution of the acid in alcohol and glycer- 
ine, in cases of cutaneous disease attended with heat and itching. 
Cystitis. Dr. Everleth writes, “ I have two cases of cystitis 
now under treatment, in which I am using a solution of one 
drachm to a pint, dissolved by the aid of borax, to rinse out the 
bladder thoroughly twice a day. I also give three grains three 
times a day, in molasses. Both are improving finely. In the first 
case, the man, from taking cold, was unable to pass water, and a 
catheter had to be used every four or six hours for seven weeks. 
The urine was very offensive and ropy, and he suffered severely 
after each catheterization. lie now passes his water naturally, 
the fetor is gone, and there is very little ropiness when the urine 
is allowed to stand. Has but little pain and is able to walk about 
the farm. 
“The other, is of a gentleman aged 92. When I first sdw him 
I found him wearing a gum catheter, introduced by another 
physician two weeks previously. Bladder required to be emptied 
every hour; urine highly alkaline, thick and very offensive; 14 
ordered the bladder washed out with the same solution as in the 
previous case, and gave tincture of iron with mix vomica. The 
patient lives ten miles away, and has to be attended by his son ; 
and, as they were afraid of difficulty in re-introducing the catheter 
so often, T allowed it to remain, and used the acid wash as a 
palliative, hoping to ease the old man down to the grave; for it 
seemed impossible he could live long. I saw him this week, and 
found him improving in every particular; can retain his urine 
three hours without inconvenience; fetor gone, appetite good, 
strength increasing, and the old man may yet live to celebrate 
his own centennial, particularly as he is of a hardy stock, a sister 
living next door to him having scored 102 last month.” 
Administration. The most of my correspondents seem to 
favor the administration of the acid in the wafers, which can now 
be had at any apothecary’s. Cachets are liked by some, and 
others give it in molasses or syrup. Nobody reports any serious 
derangement of the alimentary organs from its use in substance. 
The solution of the acid in water is promoted by the addition of 
borate of sodium or phosphate of sodium. Alcohol will make a 
better solution, but is itself objectionable in very many cases. 
The substitution of glycerine for a third of the water facilitates 
the solution of the acid. 
Conclusions. From so small a number of cases it is not 
justifiable to draw any definite and absolute conclusions. But 
we have enough evidence to warrant us in believing that we 
have in salicylic acid an agent which promises so well in certain 
directions as to make it desirable for us to industriously prose- 
cute our researches into its action in health and disease, and this 
with a reasonable hope that it will in time be accorded an honor- 
able position in our materia medica. It has been most extensively 
and satisfactorily used in rheumatism, especially in the acute 
form of the disease, and its administration has been followed by 
relief in various rheumatoid affections. Its resemblance in cer- 
tain of its physiological effects to quinia, and its apparent con- 
trol over inflammation in some cases, encourage us* to expect 
decided advantage from its use as an antipyretic. There is yet 15 
much disagreement as to its value as a topical application, though 
it is conceded by nearly all that it is very useful as a deodorant. 
More experience with reference to every point of this subject is 
needed, and this resume, of the work of a few of our members is 
presented in the hope that it may help to call attention to a 
medicinal agent of great possibilities, and encourage a more 
general and thorough examination of the claims of this and 
future New Remedies. OFFICE OF 
FREDERIC HENRY GERRISH, M. D., 
Congress St.,iiiii.iiiml Mhihvn Hi.. 
Portland, Maine, > 6, *0*77.