BISMUTH HEPATITIS

Abstract

For many years extensive use has been made of bismuth compounds in the treatment of syphilis. Hepatitis due to bismuth, however, has only recently received general recognition. The failure to realize that hepatitis may result from the use of the drug is in a large measure due to the common tendency to attribute jaundice occurring during bismuth therapy to either relapse of the disease, intercurrent infection or previously received arsphenamine. Attention was first directed to bismuth as the cause of hepatitis by Langernon, Paget and Devriendt, 1 who in 1932 reported 13 cases in which jaundice was presumably due to bismuth. Langernon and his associates believed, however, that bismuth is not hepatotoxic in the sense that the arsphenamines are but that it has rather a nonspecific effect on the liver already damaged by syphilis, alcohol or previous arsenical therapy. The occasional occurrence of hepatitis presumably due to bismuth is likewise