Acetanilidum

Volume IV — Appendix

I Antifebrinam, acetanilid, formed from aniline, CgHjNHC,H|0 ) with its derivatives, methylacetanilid (exalgine) and monobromacet* anilid.

II. Peisentngs.—i. A student with catarrh took antifebrin in repeated

doses till he had consumed almost 30 grm. He gradually beg manifest symptoms of aniline poisoning ; and, although the most prominent symptoms were absent, he complained of inability to sleep, and cardiac palpitation and dyspnoea produced a feeling as of impending death. The characteristic blueness of skin was general over the whole surface, but especially dark on eyelids, chin, and temporal regions. There was no puffiness of face, and the general appearance was quite different from that of cyanosis. On the 3rd d. patient was able to leave his bed, and the blue colour had entirely vanished, [Chemist and ■Druggisty May 31st, 1890.)

1. A healthy young married woman took about a teaspoonful in water, to relieve a headache. Ten m. later she took a similar dote, when, fearing she had overdone it, she took some milk and alum water, and vomited ; but immediately afterwards giddiness, singing in ears, throbbing in temples, and dull pain in head, together with feeling of weakness, came on, and face assumed a livid hue. Four h. later face was livid, lips blue, and pupils contracted ; but heart, temperature and mental condition were normal. An aperient and stimulant were ordered. Shortly afterwards she became suddenly collapsed, pulse could not be counted, breathing shallow. Stimulants were injected, and in 3 h. she somewhat recovered, when collapse returned ; and then an intravenous injection of common salt seemed to act most beneficially. In about 14 h. she was out of danger, but complained of debility and pain in her limbs for a week. {Lancet^ May 24th, 1890.)

2. A girl, act. 24, took exalgine to subdue the pains of myelitis^^ for 5 d. 2 gr., for 2 d. 4 gr., and finally for 7 d. 6 gr., 3 times a d. No relief was given to pain, but after the 14 d. symptoms of poisoning occurred. The first symptoms noticed were blueness of lips ana cheeks, and small compressible pulse ; she felt sick and giddy, sight Was indistinct, and there was feeling of weight at epigastrium. Amyl nitrite was given by inhalation, but this increased the cyanosis. After 5 h. patient vomited, followed by still further increase of cyanosis and delirium, with frothy salivation. Temp, rose to 99*8°, pulse to 144, small and compressible, but regular. She was treated by stimulants, strychnia and digitalis, and in 4 — 5 h. more symptoms had passed off, save slight cyanosis. [Brit. Med. Joum.^ Feb. 8th, 1890.)

3. To relieve a severe pain in lumbo-sacral region, a medical man took a gr. of exalgine at 9.30 p.m., and | h. later 2 gr. more in a little whiskey. Shortly afterwards he complained of a little giddiness, and several times said that his head felt so large it seemed to occupy the whole room. He continued, however, playing cards till 1 1 , when without warning he collapsed in his arm-chair, prostrate, quite unable to speak or move, and gasping for breath. He continued in this state for over \ h., when he got slightly better, and said a few words between his gasps ; he said he was not strong enough to move, and felt each breath a fearful effort. In this condition he was carried up to his bedroom and laid down ; but feeling unable to breathe lying down, was placed in an arm-chair well covered up before the fire. His respin> tions became painful to witness; he seized and clenched the hands ot those around him, and was in many respects just like a man suffering

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from a bad attack of asthma. Resp. was 38, gasping and shallow ; pulse quiet, rather weak ; surface very cold, face pale but notcyanosed. Was relieved in 2 h. after vomiting a little whiskey, but remained sick, giddy and weak, and for an h, suffered from frequent and painful strangury. He then got to bed and slept well, and left for Scarborough the next m. The d. following he was slightly jaundiced. During the paroxysm he felt no pain, but numbness all over, and as though diaphragm had stopped working, and he must go on breathing on his own account at any cost. He is not at all subject to asthma. {Ibid., May 3rd.)

1. Mrs. C, set. 27, took (for neuralgia) 3 gr. doses of a French preparation of exalgine at 1,2, 3, 4, and 6 p.m. without effect. At 9 she took 3 gr. more, and almost immediately afterwards felt absolutely powerless. This lasted 5 m., patient remaining quite conscious. She compared the sensation to that of taking chloroform before she was quite " under." At 12.45, P^'" still being very severe, she took a 7th dose, and in 15 m. had feeling of impending death, could not speak, gasped for breath, pallor intense, dilated pupils ; limbs became quite rigid, heart palpitated; she felt utterly powerless, and broke out into profuse perspiration. By aid of fresh air^ stimulants, &c., the attack passed off in 15 m., leaving her very prostrate, with ringing sounds in ears. {Lancet^ jSgi, I, 541.)

2. Mrs. G. had been taking 2 gr. doses of same at intervals, for a neuralgic headache, obtaining relief, though sometimes feeling slightly faint ; but by mistake an undetermined overdose was taken. She soon experienced a feeling of complete prostration, her limbs became powerless though not rigid, she felt as if she was sinking through the bed, and thought she was dying ; there was slight perspiration, breathing was faint and shallow, and she was nearly pulseless. Mustard, heat, and stimulants brought her round, but she felt very weak for many d. afterwards. [Ibid.)

3. A lady, ast. 43, for migraine occurring at the menstrual periods was given two powders of 0*25 grm, each of monobromacetanilid. She took one at 10.30 a.m., and, finding no relief, took the other at II. Her lips were then beginning to Took a little blue. At ir.30, 12.15, and 1, the headache being no better, she took 0'5 grm. of antifebrin. She became very cyanosed, and felt almost intoxicated and very giddy. At 3 p.m. headache grew worse ; clothes felt tight and their pressure almost suffocating ; she was seized with pain in 1. shoulder, starting from cardiac region and extending to tips of fingers, and for a short time lost consciousness, but soon regained it, and felt only giddy; headache persisted. Pulse was at 5 p.m. 108, very compressible j at II it was 120; respiration rose to 24 and then to 28, and temp, to 1 00' 2° ; a mitral systolic murmur developed at the apex. Nitro-glycerine (grm. ^-i^) increased the cyanosis. Alcohol, strychnia and digitalis were given at frequent intervals, and by next e. patient was practically well. {Ibid.^ Feb. 8th.)

PnchBinum, rosaniline hydrochlorate, aniline red, CjoHjpNjHCl. II, HI. I. Rosaniline hydrochlorate when perfectly pure is said to

have no marked physiological action. Fabrics dyed with it have acted u local irritants producing eczema ; but it is probable that this effect may be due, at least in great part, to the presence of arsenic. ^Vjjen given internally, it has produced salivation, vomiting, diarrhoea ; and wrhen injected into the veins it has caused trembling, staggering, albuminuria, and fatty degeneration of the kidneys. These symptoms may possibly be due to the presence of aniline or of arsenic as impuritiu. It is excreted by the kidneys, saliva, and bile ; and probably also by the intestinal mucous membrane.* (Brunton, Pharmat., &c., p. 743.)