Acidum salicylicum. (C6 H4 OH, COOH). Salicylic acid. Trituration. Natrum salicylicum. (C6 H4 OH, COONa). Salicylate of soda. Solution. Methyl salicylas. (C6 H4 OH, COOCH3). Oil of wintergreen. Acidum acetyl-salicylicum. (C6 H3 O-OC6 H4, COOH). Aspirin Salicinum. C13 H18 O7). Salicin: a glucoside obtained from several species of willow and poplar.
SALICYLIC ACID is an antiseptic. This property is largely dependent on its acidity and therefore is practically absent in its salt, the salicylates. As an antiseptic it has the advantage of not evaporating as it is non-volatile and can therefore be exposed to the air longer than most other preservatives. When applied as powder to wounds, mucous membrane or skin salicylic acid slowly induces corrosion and necrosis and when swallowed causes irritation of the mouth and throat and discomfort in the stomach, frequently with nausea and vomiting. The salicylates are scarcely at all irritant but, when swallowed, the hydrochloric acid of the gastric juice may combine with the base and set free some of the salicylic acid, which will then irritate the stomach and give rise to dyspepsia. Both salicylic acid and the salicylates are rapidly absorbed from the stomach and circulate in the blood as sodium salicylate; they are as rapidly excreted by the kidneys but some small proportion appears in the milk, perspiration and bile.
Nervous system.- Salicylates caused depression of the central nervous system, as shown by slowness, weakness and incoordination of voluntary movements, and eventually by stupor and paralysis of respiration, which is cause of death.
Secretion of urine and bile are both increased. Albumin and casts are sometimes found in the urine and three may be haemorrhage from the kidneys as well as from the nose, gums, intestines and uterus.
The heart is at first stimulated and the pulse quick, soft and compressible, but it soon becomes slow and feeble from dilatation and weakness of the heart. The blood-pressure is first raised and then lowered from stimulation followed by depression of the vasomotor centre. Metabolism is considerably modified, as shown by the fact that there is an increase of 10 to 12 percent in the nitrogen of the urine and of 30 to 45 per cent. in the uric acid. Salicylates do not usually lower the temperature in healthy people, except in a very small degree, but in a few cases a rise has been observed. Aspirin passes through the stomach unchanged and therefore does not produce the gastric symptoms of salicylates. Like them it circulates in the blood as the sodium salt but has an action like the antipyretics in headache and neuralgia; this is perhaps due to some of it escaping metamorphosis into sodium salicylate.
The ordinary symptoms caused by non-poisonous but material doses of salicylates are dulness and confusion of mind, heaviness and fulness of the head, hissing and roaring sounds in the ears with vertigo and hardness of hearing, indistinct sight, profuse perspiration with which there is a sensation of warmth all over the body from dilatation of the blood-vessels in the skin and various forms of skin eruption which may be erythematous patches, urticarial wheals or petechiae.
With poisonous doses dyspnoea with exceedingly deep and laboured breathing-more thoracic than diaphragmatic-ensues, and there may be collapse with slow, weak pulse and subnormal temperature, or delirium with visual hallucinations of transient duration.
Give some additions to the above. The headaches of salicylic acid are frontal and are worse from movement, they are heavy and compressive and may be associated with numbness and insensibility of the scalp, or a feeling as of blood circulating in the skull. There is giddiness with objects appearing to move to the right, worse on raising the head, better lying still.
Digestive System.-Redness and swelling of the mucous membrane of the palate and throat were caused in one prover, the right tonsil was swollen and from it was expelled a foul smelling, cheesy plug, a condition resembling follicular tonsillitis. A constant bitter taste is noticed in the mouth, and a severe and persistent pressure in the lower abdomen, as from incarcerated flatus, is experienced.
Genito-urinary.-There is some irritability in the bladder and an excess of triple and earthy phosphates in the urine. The menses are too early, too profuse and last too long.
Eyes.-Flickering and sparks are seen before the eyes, the conjunctivae are injected and the pupils dilated. Sight is dim. Divergent strabismus occurred in one prover.
In the ear are persistent ringing, singing and buzzing sounds, with varying degrees of deafness.
Nasal symptoms are constant sneezing, epistaxis and a smell of musk (subjective). The voice is thick and speech jerky and indistinct or stammering from an apparent inability of the mouth to forms words properly.
Chest.-A sore pain is felt in both sides of the chest just below the nipples accompanied with a sensation of tightness and a desire to draw a deep breath and to move the arms. Burning sensations are felt in the region of the heart.
The face is flushed and perspiring, the lips tremble in speaking and the lips and tongue cannot be exercised with the proper freedom. The right parotid is swollen and the skin on the forehead is tender to touch. Limbs.-A great many pains of a rheumatic character are caused by the salicylates in the back and limbs, many of them sudden and sharp and quickly changing their locality, others aching and sore; they occur in all parts, but one may specially mention a distressing pain in the middle of the dorsal vertebrae with desire to press the back against something, pain in the lumbar muscles, about the elbows, and in the ankles and feet. Uncontrollable twitchings occur in the legs and feet, jerks and tremors in the lower limbs and tremors in the hands when they are held out. Painful parts are sore to touch. In one prover a carbuncle appeared on the back of the neck. There is decided muscular weakness as well as muscular irritability; muscles easily contract on tapping them. There is an uncertainty in the patient’s movements and a paretic inclination of the body to the right. Fugitive pains occur all over the body and there is general malaise and chilliness and a disposition to lie down sleep. At night the patient wakes frequently, first feeling too hot, then chilly, and towards morning break out into profuse perspiration.
Salicylic acid has been used locally to prevent excessive sweating especially of the feet to which it has been applied in powder in the stocking; and also to soften the hard epidermis of corns and warts, in which case a solution dissolved in collodion (30 gr. of salicylic acid to 1 dr. of collodion) is painted on the hardened skin.
Methyl salicylate is often applied locally in muscular and articular rheumatism; absorption takes place through the skin but irritation is liable to occur.
The salicylates have gained their chief reputation as a specific in acute articular rheumatism. Given in material doses (10 to 20 gr. frequently repeated) they rapidly ease pain and reduce the fever in this disease. They do not lessen the liability to endocarditis and pericarditis, nor do they diminish the time during which it is necessary for the patient to be under treatment, and it is considered by many that relapses are more frequent when salicylates are given. Moreover, several cases of sudden collapse have occurred during treatment with salicylates in rheumatic fever and, though they usually quickly lower the temperature they have no power to prevent hyperpyrexia or to reduce it when present.
It seems that salicylates counteract the rheumatic poison in its effects on the muscular and fibrous tissues and on the heat- regulating centres but have no power over the source of the poison, which probably is to be found in the small nodular growths in the heart and scattered about the body and which are analogous to the tubercles of tuberculous disease.
It is to be noticed that the salicylates have no specific action on joint pains unless they are due to the rheumatic poison, for instance, they are useless in gonorrhoeal arthritis. So much is this the case that they are used as a means of diagnosis between rheumatic and non-rheumatic affections of joints.
Salicylates have no such especial relationship to rheumatic arthritis as would mark them as pre-eminently homoeopathic to that disease. It is true that they cause pains in the muscles and tendons, and swellings in the joints of a rheumatic character, which leads one to think they should be useful, and many cases of cure by them in minute doses have been recorded; but the indications for their employment are not very well defined, and they have played only a minor part in the Homoeopathic treatment of rheumatic fever or of rheumatic pains in general; other drugs have been found more valuable. The inflammation of the throat and tonsils occurring in the provers suggest the employment of a salicylate in tonsillitis whether of rheumatic or other origin. Natrum salicylatum has been curative in periosteal rheumatism when the parts are hot and tender, and associated with an irregular, soft pulse and the profuse, musty smelling perspiration, and with a temperature that increases and diminishes with the degree of periosteal pain.
The complaint for which the salicylates have been most employed by homoeopaths is Meniere`s disease. Here the association of giddiness, noise in the ears and deafness is exactly paralleled by the drug, and it has been used with great effect. It has been found valuable also for simple deafness with tinnitus; the deafness is direct and perosseous as well as through the air; it is similar to that caused by quinine and, like it, is usually transient, though in each case permanent effects occasionally result.
Natrum salicylicum or salicylic acid should be thought of for divergent strabismus and for stammering.
A case of scrofulous caries cured by salicylic acid has been reported (Monthly Homoeopathic Review).
Its symptoms of general depression, languor, muscular weakness and rheumatic pains have suggested its employment in post-influenzal debility, and it has been found serviceable in that condition.
(1) Rheumatic pains in limbs and joints; periosteal rheumatism; tonsillitis.
(2) Meniere`s disease. Tinnitus with deafness.
(3) Pains quickly change their locally and painful parts are sore to touch.
From motion, cold air.
From hot applications, esp. dry heat.