METHEMOGLOBINEMIA FOLLOWING THE ADMINISTRATION OF BISMUTH SUBNITRATE

Abstract

The literature of a quarter of a century ago contains many reports emphasizing the hazard of nitrite poisoning, or methemoglobin formation, following the oral administration of large doses of bismuth subnitrate used either in the treatment of diarrheas or for roentgenologic studies. That these warnings still bear emphasis is evident from some of the statements in modern textbooks. Six consecutive pediatric textbooks were consulted on the treatment of summer diarrhea. Without exception, every one recommended the use of bismuth salts without pointing out the possible dangers of poisoning following the oral administration of large doses of bismuth subnitrate. In one of these books appears the statement that "bismuth subnitrate in not less than 10 grain doses at two hour intervals has given most satisfactory results and in order to be of service it must produce black stools." No warning is given of the danger of nitrite poisoning. These observations have