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September 1963, Vol 106, No. 3 >
Article | September 1963

Salicylism FREE

PAUL N. TSCHETTER, MD
[+] Author Affiliations

Submitted for publication March 8, 1963.


Am J Dis Child. 1963;106(3):334-346. doi:10.1001/archpedi.1963.02080050336016.
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Comments

The clinical picture of salicylism may be caused by a number of related compounds; the effects exerted by these chemicals act by virtue of their salicylic acid content. The compounds commonly causing intoxication are sodium salicylate, methyl salicylate, acetylsalicylic acid (aspirin)1 and the salicylamides (the new liquid aspirin compounds).2

One of the problems of salicylate intoxication involves availability. In the United States more acetylsalicylic acid is consumed than any other drug,3 and between 1952 and 1956, salicylates were responsible for 541 fatalities or 7.7% of the deaths due to accidental poisoning.4 Three hundred eighty of the deaths occurred in children under five years of age.4 In 1956, 18% of all poisonings of children under five years of age involved salicylates.5 Over a two-year period, the Boston Children's Medical Center Emergency Room reported 486 cases of accidental poisoning; 30% of these were due to salicylates.6 In 1956 to 1958, 29 Poison

REFERENCES

1 +
Goodman, L. S., and Gilman, A.: The Pharmacological Basis of Therapeutics , ed 2, New York: The Macmillan Company, 1955;.
2 +
Fruthaler, G. J., and Snyder, C. H.:  Poisoning in Childhood , Pediat Clin N Amer 9:41, 1962;.
3 +
Gleason, M. N.; Gosselin, R. E.; and Hodge, H. C.: Clinical Toxicology of Commercial Products , Acute Poisoning, Baltimore: Williams & Wilkins Company, 1957;.
4 +
Cann, H. M.; Neyman, D. S.; and Verhulst, H. L.:  Control of Accidental Poisoning: A Progress Report , JAMA 168:717, 1958;.
5 +
Cann, H. M., and Verhulst, H. L.:  The Salicylate Problem With Special Reference to Methyl Salicylate , J Pediat 53:271, 1958;.
6 +
Glicklich, D.:  Toxic Hazards: Salicylate Poisoning , New Engl J Med 259:144, 1958;.
7 +
Spector, S.:  Management of Acute Aspirin Poisoning in Children , Quart Rev Pediat 13:179, 1958;.
8 +
Done, A. K., and Otterness, L. J.:  Exchange Transfusion in the Treatment of Oil of Wintergreen (Methyl Salicylate) Poisoning , Pediatrics 18:80, 1956;.
9 +
Rentsch, J. B.; Bradley, A.; and Marsh, S. B.:  Two Cases of Salicylate Intoxication Successfully Treated by Exchange Transfusion , AMA J Dis Child 98:778, 1959;.
10 +
Segar, W. E., and Holliday, M. A.:  Physiologic Abnormalities of Salicylate Intoxication , New Engl J Med 259:1191, 1958;.
11 +
Winters, R. W.:  Salicylate Intoxication in Infants and Children , Pediat Clin N Amer 6:281, 1959;.
12 +
Tenney, S. M., and Miller, R. M.:  Respiratory and Circulatory Actions of Salicylate , Amer J Med 19:498, 1955;.
13 +
Miller, R. H., and Tenney, S. M.:  Action of Sodium Salicylate on Tissue Gas Tensions , Proc Soc Exp Biol Med 92:791, 1956;.
14 +
Talbot, N. B.; Richie, R. H.; and Crawford, J. D.: Metabolic Homeostasis , Cambridge, Mass: Harvard University Press, 1959;.
15 +
Segar, W. E., and Holliday, M. A.:  Physiologic Abnormalities of Salicylate Intoxication , New Engl J Med 259:1191, 1958;.
16 +
Riley, H. D., Jr., and Worley, L.:  Salicylate Intoxication , Pediatrics 18:578, 1956;.
17 +
Kaplan, S. A., and del Carmen, F. T.:  Experimental Salicylate Poisoning: Observations on the Effects of Carbonic Anhydrose Inhibitor and Bicarbonate , Pediatrics 21:762, 1958;.
18 +
Dubow, E., and Solomon, N. H.:  Salicylate Tolerance and Toxicity in Children , Pediatrics 1:495, 1948;.
19 +
Done, A. K.:  Salicylate Intoxication: Significance of Measurements of Salicylate in Blood in Cases of Acute Ingestion , Pediatrics 26:800, 1960;.
20 +
Arnold, F. J., Jr.; Hodges, J. B., Jr.; and Barta, R. A., Jr.:  Evaluation of the Efficacy of Lavage and Induced Emesis in Treatment of Salicylate Poisoning , Pediatrics 23:286, 1959;.
21 +
Spector, S.: "Comment," Chicago: Year Book of Pediatrics , edited by Sidney S. Gellis, The Year Book Publishers, 1958;, p 473.
22 +
Bates, T., and Grunwaldt, E.:  Ipecac Poisoning: A Report of Two Cases of Ingestion of Fluid Extract of Ipecac , Amer J Dis Child 103:169, 1962;.
23 +
Allport, R. B.:  Ipecac is Not Innocuous , AMA J Dis Child 98:786, 1959;.
24 +
Adams, W. C.:  Emetics in Accidental Poisoning , Pediat Clin N Amer 8:351, 1961;.
25 +
Robertson, W. O.:  Syrup of Ipecac: A Slow or Fast Emetic? Amer J Dis Child 103:136, 1962;.
26 +
Abel, J. J.; Rowntree, L. G.; and Turner, B. B.:  On the Removal of Diffusible Substances from the Circulating Blood of Living Animals by Dialysis , J Pharmacol Exp Ther 5:275, 1913;-1914.
27 +
Doolan, P. D.; Walsh, W. P.; Kyle, L. H.; and Wishinsky, H.:  Acetylsalicylic Acid Intoxication: A Proposed Method of Treatment , JAMA 146:105, 1951;.
28 +
Schreiner, G. E.; Berman, L. B.; Griffin, J.; and Feys, J.:  Specific Therapy for Salicylism , New Engl J Med 253:213, 1955;.
29 +
Etteldorf, J. N.; Dobbins, W. T.; Summitt, R. L.; Rainwater, W. T.; and Fisher, R. L.:  Intermittent Peritoneal Dialysis Using Five Per Cent Albumin in the Treatment of Salicylate Intoxication in Children , J Pediat 58:226, 1961;.
30 +
Elliott, G. B., and Critchton, J. U.:  Peritoneal Dialysis in Salicylate Intoxication , Lancet 2:840, 1960;.
31 +
Segar, W. E.; Gibson, R. K., and Rhamy, R.:  Peritoneal Dialysis in Infants and Small Children , Pediatrics 27:603, 1961;.
32 +
Leikin, S. L., and Emmanouilides, G. C.:  The Use of Exchange Transfusion in Salicylate Intoxications: Report of Seven Cases , J Pediat 57:715, 1960;.
33 +
Earle, R., Jr.:  Hazards to Health: Congenital Salicylate Intoxication; Report of a Case , New Engl J Med 265:1003, 1961;.
34 +
James, J. A.; Kimbell, L.; and Read, W. T.:  Comparison of Exchange Transfusion, Intermittent Peritoneal Lavage, and Hemodialysis as Means for Removing Salicylate , Pediatrics 29:442, 1962;.
35 +
Strauss, J., and Nahas, G. G.:  Use of Amine Buffer (THAM) in Treatment of Acute Salicylate Intoxication , Proc Soc Exp Biol Med 105:348, 1960;.
36 +
Kaplan, S. A.:  Tris (Hydroxymethyl) Aminomethane (THAM): A New Buffer for Therapeutic Use , Amer J Dis Child 103:1, 1962;.
37 +
Schwartz, R.; Fellers, F. X.; Knapp, J.; and Yaffe, S.:  The Renal Response to Administration of Acetazolamide (Diamox) During Salicylate Intoxication , Pediatrics 23:1103, 1959;.
38 +
Feuerstein, R. C.; Finberg, L.; and Fleishman, E.:  The Use of Acetazoleamide in the Therapy of Salicylate Poisoning , Pediatrics 25:215, 1960;.
39 +
Oliver, T. K., Jr., and Dyer, M. E.:  The Prompt Treatment of Salicylism with Sodium Bicarbonate , Amer J Dis Child 99:553, 1960;.
40 +
Whitten, C. F.; Kesaree, N. M.; and Goodwin, J. F.:  Managing Salicylate Poisoning in Children: An Evaluation of Sodium Bicarbonate Therapy , Amer J Dis Child 101:178, 1961;.
41 +
Friedman, S. B., and Stocks, J. F.:  Observations on the Treatment of Salicylism in Children , New Engl J Med 265:1237, 1961;.
42 +
Spritz, N.; Fahey, T. J., Jr.; Thompson, D. B.; and Rubin, A. L.: The Use of Extracorporeal Hemodialysis in the Treatment of Salicylate Intoxication in a Two-Year-Old Child 24:540, 1959;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Goodman, L. S., and Gilman, A.: The Pharmacological Basis of Therapeutics , ed 2, New York: The Macmillan Company, 1955;.
2 +
Fruthaler, G. J., and Snyder, C. H.:  Poisoning in Childhood , Pediat Clin N Amer 9:41, 1962;.
3 +
Gleason, M. N.; Gosselin, R. E.; and Hodge, H. C.: Clinical Toxicology of Commercial Products , Acute Poisoning, Baltimore: Williams & Wilkins Company, 1957;.
4 +
Cann, H. M.; Neyman, D. S.; and Verhulst, H. L.:  Control of Accidental Poisoning: A Progress Report , JAMA 168:717, 1958;.
5 +
Cann, H. M., and Verhulst, H. L.:  The Salicylate Problem With Special Reference to Methyl Salicylate , J Pediat 53:271, 1958;.
6 +
Glicklich, D.:  Toxic Hazards: Salicylate Poisoning , New Engl J Med 259:144, 1958;.
7 +
Spector, S.:  Management of Acute Aspirin Poisoning in Children , Quart Rev Pediat 13:179, 1958;.
8 +
Done, A. K., and Otterness, L. J.:  Exchange Transfusion in the Treatment of Oil of Wintergreen (Methyl Salicylate) Poisoning , Pediatrics 18:80, 1956;.
9 +
Rentsch, J. B.; Bradley, A.; and Marsh, S. B.:  Two Cases of Salicylate Intoxication Successfully Treated by Exchange Transfusion , AMA J Dis Child 98:778, 1959;.
10 +
Segar, W. E., and Holliday, M. A.:  Physiologic Abnormalities of Salicylate Intoxication , New Engl J Med 259:1191, 1958;.
11 +
Winters, R. W.:  Salicylate Intoxication in Infants and Children , Pediat Clin N Amer 6:281, 1959;.
12 +
Tenney, S. M., and Miller, R. M.:  Respiratory and Circulatory Actions of Salicylate , Amer J Med 19:498, 1955;.
13 +
Miller, R. H., and Tenney, S. M.:  Action of Sodium Salicylate on Tissue Gas Tensions , Proc Soc Exp Biol Med 92:791, 1956;.
14 +
Talbot, N. B.; Richie, R. H.; and Crawford, J. D.: Metabolic Homeostasis , Cambridge, Mass: Harvard University Press, 1959;.
15 +
Segar, W. E., and Holliday, M. A.:  Physiologic Abnormalities of Salicylate Intoxication , New Engl J Med 259:1191, 1958;.
16 +
Riley, H. D., Jr., and Worley, L.:  Salicylate Intoxication , Pediatrics 18:578, 1956;.
17 +
Kaplan, S. A., and del Carmen, F. T.:  Experimental Salicylate Poisoning: Observations on the Effects of Carbonic Anhydrose Inhibitor and Bicarbonate , Pediatrics 21:762, 1958;.
18 +
Dubow, E., and Solomon, N. H.:  Salicylate Tolerance and Toxicity in Children , Pediatrics 1:495, 1948;.
19 +
Done, A. K.:  Salicylate Intoxication: Significance of Measurements of Salicylate in Blood in Cases of Acute Ingestion , Pediatrics 26:800, 1960;.
20 +
Arnold, F. J., Jr.; Hodges, J. B., Jr.; and Barta, R. A., Jr.:  Evaluation of the Efficacy of Lavage and Induced Emesis in Treatment of Salicylate Poisoning , Pediatrics 23:286, 1959;.
21 +
Spector, S.: "Comment," Chicago: Year Book of Pediatrics , edited by Sidney S. Gellis, The Year Book Publishers, 1958;, p 473.
22 +
Bates, T., and Grunwaldt, E.:  Ipecac Poisoning: A Report of Two Cases of Ingestion of Fluid Extract of Ipecac , Amer J Dis Child 103:169, 1962;.
23 +
Allport, R. B.:  Ipecac is Not Innocuous , AMA J Dis Child 98:786, 1959;.
24 +
Adams, W. C.:  Emetics in Accidental Poisoning , Pediat Clin N Amer 8:351, 1961;.
25 +
Robertson, W. O.:  Syrup of Ipecac: A Slow or Fast Emetic? Amer J Dis Child 103:136, 1962;.
26 +
Abel, J. J.; Rowntree, L. G.; and Turner, B. B.:  On the Removal of Diffusible Substances from the Circulating Blood of Living Animals by Dialysis , J Pharmacol Exp Ther 5:275, 1913;-1914.
27 +
Doolan, P. D.; Walsh, W. P.; Kyle, L. H.; and Wishinsky, H.:  Acetylsalicylic Acid Intoxication: A Proposed Method of Treatment , JAMA 146:105, 1951;.
28 +
Schreiner, G. E.; Berman, L. B.; Griffin, J.; and Feys, J.:  Specific Therapy for Salicylism , New Engl J Med 253:213, 1955;.
29 +
Etteldorf, J. N.; Dobbins, W. T.; Summitt, R. L.; Rainwater, W. T.; and Fisher, R. L.:  Intermittent Peritoneal Dialysis Using Five Per Cent Albumin in the Treatment of Salicylate Intoxication in Children , J Pediat 58:226, 1961;.
30 +
Elliott, G. B., and Critchton, J. U.:  Peritoneal Dialysis in Salicylate Intoxication , Lancet 2:840, 1960;.
31 +
Segar, W. E.; Gibson, R. K., and Rhamy, R.:  Peritoneal Dialysis in Infants and Small Children , Pediatrics 27:603, 1961;.
32 +
Leikin, S. L., and Emmanouilides, G. C.:  The Use of Exchange Transfusion in Salicylate Intoxications: Report of Seven Cases , J Pediat 57:715, 1960;.
33 +
Earle, R., Jr.:  Hazards to Health: Congenital Salicylate Intoxication; Report of a Case , New Engl J Med 265:1003, 1961;.
34 +
James, J. A.; Kimbell, L.; and Read, W. T.:  Comparison of Exchange Transfusion, Intermittent Peritoneal Lavage, and Hemodialysis as Means for Removing Salicylate , Pediatrics 29:442, 1962;.
35 +
Strauss, J., and Nahas, G. G.:  Use of Amine Buffer (THAM) in Treatment of Acute Salicylate Intoxication , Proc Soc Exp Biol Med 105:348, 1960;.
36 +
Kaplan, S. A.:  Tris (Hydroxymethyl) Aminomethane (THAM): A New Buffer for Therapeutic Use , Amer J Dis Child 103:1, 1962;.
37 +
Schwartz, R.; Fellers, F. X.; Knapp, J.; and Yaffe, S.:  The Renal Response to Administration of Acetazolamide (Diamox) During Salicylate Intoxication , Pediatrics 23:1103, 1959;.
38 +
Feuerstein, R. C.; Finberg, L.; and Fleishman, E.:  The Use of Acetazoleamide in the Therapy of Salicylate Poisoning , Pediatrics 25:215, 1960;.
39 +
Oliver, T. K., Jr., and Dyer, M. E.:  The Prompt Treatment of Salicylism with Sodium Bicarbonate , Amer J Dis Child 99:553, 1960;.
40 +
Whitten, C. F.; Kesaree, N. M.; and Goodwin, J. F.:  Managing Salicylate Poisoning in Children: An Evaluation of Sodium Bicarbonate Therapy , Amer J Dis Child 101:178, 1961;.
41 +
Friedman, S. B., and Stocks, J. F.:  Observations on the Treatment of Salicylism in Children , New Engl J Med 265:1237, 1961;.
42 +
Spritz, N.; Fahey, T. J., Jr.; Thompson, D. B.; and Rubin, A. L.: The Use of Extracorporeal Hemodialysis in the Treatment of Salicylate Intoxication in a Two-Year-Old Child 24:540, 1959;.

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