- rosive properties have long pointed it out to the surgeon as the most
convenient of all escharotics.
Nitrate of silver is absorbed, however, in the course of its action. It would seem to be absorbed when it is taken medicinally in frequent small doses. It is not easy to account otherwise for the singular blueness of the skin, sometimes observed after the protracted use of lunar caustic as a remedy for epilepsy and other diseases.[1] The effects of the poison on the constitution in such cases are not very well known. It appears, however, that considerable doses may be taken for a great length of time without injury, and that the first and only unpleasant effects produced by its too free administration are such as indicate simply an injury of the stomach. The only exception to this general statement I have met with is a case by Wedemeyer, where, after the remedy had been taken for six months on account of epilepsy, that disease disappeared, and dropsy, with diseased liver at the same time commenced, and soon proved fatal. It is probable, however, that the nitrate of silver had no share in the ultimate event. In this instance the whole internal organs were more or less blue; and metallic silver, it is said, was found in the pancreas, and in the choroid plexus of the brain.[2] Silver has been found in the urine of persons who were taking it medicinally. A young man who had used the nitrate for some time observed that his urine became muddy soon after being passed, and that the sediment became black if exposed to the light; and when the sediment was digested in ammonia, chloride of silver was detached by neutralizing the ammoniacal liquor.[3]
But it also appears that some nitrate of silver is absorbed when it is given in a single large dose. For in animals poisoned with it Orfila found that silver may be detected in the liver and spleen by charring these organs with nitric acid as in the instance of poisoning with copper, and then treating the residue with boiling diluted nitric acid, and adding hydrochloric acid to the solution. He also found silver in the urine by charring the extract with heat, acting on the charcoal with ammonia, and saturating the filtered ammoniacal solution,—chloride of silver being then detached.[4] These results have been confirmed by the experiments of Drs. Panizza and Kramer of Milan,[5] who found silver in the blood after the administration both of the nitrate and chloride.
Boerhaave has noticed a case of poisoning with this substance, but in very brief terms. He says it caused gangrene. Schloepfer in his thesis notices a case by Dr. Albers of Bremen in which croup was brought on by a bit of lunar caustic dropping into the windpipe. M. Poumarede has related an instance of poisoning with an ounce of nitrate of silver in solution. A few hours afterwards the individual
