SALICYLATE OF SODIUM IN THE TREAT- 
MENT OF IRITIS 
RY 
JULIAN J. CHISOLM, M.D. 
PROFESSOR OF EYE DISEASES IN THE UNIVERSITY OF MARYLAND. 
[Reprinted from the Archives of Ophthalmology, Vol. ix, No. 2, 
June 1, 1880.] SALICYLATE OF SODIUM IN THE TREATMENT 
OF IRITIS. 
By JULIAN J. CHISOLM, M.D. 
PROFESSOR OF EYE DISEASES IN THE UNIVERSITY OF MARYLAND. 
SALICYLATE of sodium has accomplished good work 
at the Presbyterian Eye and Ear Hospital of Balti- 
more, in the treatment of acute scleral and iritic inflam- 
mations.* In the latter disease especially has its effects 
been the most satisfactory, and its controlling action the 
most prompt. Its good work has been exhibited in cases 
of idiopathic iritis, whether the inflammation originated 
from specific poisoning or from other internal causes. In 
many cases the disease, when at its height, is influenced 
so readily that, in the course of 24 hours, a marked im- 
provement is experienced in the symptoms, with relief from 
pain and a subsidence of the injection, a satisfactory evi- 
dence that the paroxysm of acute iritis has had a serious 
check. In comparatively a few hours convalescence sets in, 
and is steadily progressive to a speedy and perfect cure of 
the acute inflammatory process. 
The doses necessary to bring about these good results 
are large, and must be frequently repeated at short inter- 
vals. Water forms a ready solvent for the salt, to which 
any aromatic addition, as tincture of cardimon, ginger, 
orange peel or extract of liquorice, may be made to mask 
its disagreeable taste, and to complete what is usually called 
* Publicity in Baltimore was first given to the efficacy of Salicylate of So- 
dium in iritic diseases, by Dr. Wm. J. McDonnell at that time one of the medi- 
cal staff of the Hospital, in an article read before the State Medical Society of 
Maryland in April 1879, and published in the society transactions for that year. 
Reprinted from the Archives of Ophthalmology, Vol. ix, No. 2, June, 
1880. Julian J. Chisolm. 
2 
by dispensing druggists an elegant preparation. For hospi- 
tal work the dose is 20 to 30 grains taken in a wineglass of 
water, and repeated every three hours, making from 150 to 
200 grains of the salicylate of sodium for the first 24 hours 
of treatment, to be continued until the desired effects are 
produced. Should the paroxysm show decided indications 
of yielding at the end of the first day, the intervals may 
be increased to four hours, then to three times a day, slowly 
tapering off until the remedy is no longer needed. At 
times the stomach is much irritated by these doses, and 
nausea, even to vomiting, is induced. The head will ring 
as if from full doses of quinine, and temporary deafness is 
a very common sequel of the liberal administration of this 
drug. Some of my patients have complained of cerebral 
excitement, and even of hallucination, not always in a 
pleasant form. All of these disagreeable symptoms have 
promptly disappeared when the remedy is discontinued, 
and do not always accompany its administration. 
If decided benefit is not observed in 48 to 72 hours the 
salt is not likely to prove useful in the given case, and the 
stomach and head disturbances require a change of treat- 
ment. I have promptly checked recurrent attacks of specific 
iritis in a few days by the administration of the salicylate 
of sodium, which, under the usual treatment of mercury 
and the iodide of potash, would necessitate weeks of medi 
cation to bring about the same salutary results. With 
the salicylate treatment mydriatics, of course, cannot be 
omitted. 
The following report of a case only recently under treat- 
ment, exhibits the controlling influences of salicylate of 
sodium more conspicuously than any other which has come 
under my observation. 
Miss M., jet. 50, residing in Washington, D. C., was operated 
upon six years since by iridectomy for an acute attack (fulmin- 
ans) of glaucoma in both eyes. Sight was rapidly reduced to 
shadows, and the pain was very severe. The operation gave 
speedy relief, and within two months they lad had resumed ac- 
tive work in a large school, to which she added extra hours of 
study in the preparation of school books. Six months of this Salicylate of Sodinm in the Treatment of Iritis. 
3 
over eye work brought on a second attack of glaucoma, which 
necessitated the removal of an additional piece of iris from each 
eye, until nearly one-quarter of the iritic septum was taken away. 
The extensive corneal wound with loss of so much iris have 
given her six years of comfort and good eye-sight. In the 
left eye, her best, in which she has very acute sight, although she 
reads brilliant with either eye, there has been a small cystoid 
cicatrix, with a little end of incarcerated iris. This little blister 
would frequently rupture, and by taking off tension from the 
anterior chamber would give comfort ; in other respects it would 
cause a very disagreeable feeling of grit, and would often be sur- 
rounded by a blush in the sclera prior to rupture. For nearly 
four years this little annoyance has been going on. Frequently 
she would have the vesicle stuck by her family physican, and 
at times he was induced to apply to it a point of nitrate of 
silver. 
Six weeks since this left eye suddenly became very painful, 
highly injected, with very blurred vision. The physician called 
to see her, leeched her temple freely, and expressed such anxiety 
as to the seriousness of the disease that she was induced to take 
the train the next day for Baltimore, so that 48 hours from the 
commencement of this present trouble she came under my obser- 
vation. I found her with all the prominent symptoms of an acute 
attack of iritis. The eye was highly injected, with slight increase 
of tension, and was very painful. The large coloboma was 
muddy, but exhibited no tendency to contraction. The iris was 
quite greenish when contrasted with the blue iris of the right eye, 
and some pus was sharply defined at the lower portion of the 
anterior chamber. Vision was reduced to the counting of fingers 
at one foot from the eye, and a turbid vitreous rendered it impos- 
sible to make a fundus examination with the ophthalmoscope. 
As the increased tension was not very decided, and the symptoms 
of iritis were by far the most conspicuous, I had the artificial 
leech applied, and commenced at once the salicylate of sodium 
treatment in 25-grain doses, at intervals of hours. The ad- 
ministration was faithfully carried out during the night, and on 
the next day, at the end of 24 hours, the appearances of the eye 
were markedly improved. All pus had disappeared from the 
chamber, and the conjunctival congestion was much paler. Pain 
had decidedly lessened, and the patient had a very comfortable 
eye, but she complained much of the effects of the remedy upon 4 
Julian J. Chisolm. 
stomach and head. She was deaf, buzzing and nauseated, and 
complained of queer feelings. Notwithstanding her discomfort I 
urged her, for the sake of saving her eye, to continue with the 
remedy for another day in increased intervals of from three to 
four hours. At the expiration of 48 hours the improvement 
could not be questioned. The iris had regained its blue color, 
and the pupil had lost much of its muddy look. She could count 
fingers much further off, but could not yet distinguish beyond 
number xx of Jtiger’s test type. All pain had gone, and much of 
the redness with it. She now complained so much of the dis- 
agreeable effects of the salicylate, and specially the hallucination 
of frightful faces jeering at her, that I was compelled to substi- 
tute for this salt the iod. potash. Convalescence had been, how- 
ever, already well established, and the improvement in vision was 
so marked from day to day that she returned to her school work 
within a fortnight. She finally regained the perfect use of her 
eyes, reading easily the No. 1 of Jiiger with the cylinder glasses, 
which correct the traumatic astigmatism sequel of the extensive 
corneal incision of six years ago.