The prolonged use of acetanilid is cer tainly not without danger. This may be of two kinds: 1. The production of marked and more or less transient changes in blood-composition from its long use. 2. Cumulative power in the drug. Robert Haley (Weekly Med. Re view, Nov. 9, '89).
Acetanilid used in 1100 cases of dis eases of children, in 600 of which a record was kept. Conclusions are: (1) with due care it is a reliable remedy for infancy and childhood; (2) the re sults are of longer duration and the de pression not so great as from the use of antipyrine; (3) the cyanosis which may accompany its use is not dangerous and soon passes away: (4) small. but re peated, doses should he used. I. N. Love (Jour. Amer. Med. Assoc., Mar. 29. '90).
Acetanilid habit in a negro adult suf fering from rheumatism. The man found that he was relieved by its administra tion, but that on leaving off the drug a few days the pain returned. He began taking it constantly each day and now uses 2 ounces a week. G. W. Gaines (N. 0. Med. and Surg. Jour., July, 1900). Its prolonged administration, even in small doses, may give rise to sudden and marked anemia and to temporary mental aberration. Experiments in animals have shown that prolonged use tends to cause fatty degeneration of the heart, liver, and kidneys.
Two cases in which gradual loss of memory was produced by long-continued administration (5 to 30 grains) of ace tanilid. Memory regained by stopping the drug. Joseph Haigh (Medical World, Oct., 'S9).
Report of twenty-five physicians of New South Wales. Opinion that symp toms of depression and collapse are more readily produced and are more marked than with antipyrine may be explained by the fall of temperature being greater and more rapid. Most of the reports mention cyanosis to a greater degree that after antipyrine. Antemia may be induced by its continued use and become a grave condition. D. R. Paterson (Prac titioner, No. 304, '93).
Acetanilid Poisoning. — _1cetanilid gives rise to severe symptoms of intox ication more frequently than any other agent belonging to the aromatic series, with the exception, perhaps, of antipy rine.
When poisonous doses are taken, there is marked cyanosis, prostration, shallow and labored respiration, palpitation of the heart, weak and thready irregular pulse, dilatation of the cold extremities, subnormal temperature, cold sweats, and other symptoms of collapse. The drug would therefore seem to be a depressant to the functions of respiration and cir culation, with disturbance of the vaso motor system and probably of the heat regulating centres.
Case of poisoning by acetanilid, in a lady 36 years of age, who had taken about 40 grains in divided doses. in the course of four hours. The chief symp toms exhibited were semi-unconscious ness; delirium; a very feeble pulse; short, rapid breathing; cyanosis of face and lips; and cold extremities. The patient recovered under the use of alco holic stimulants and the hypodermic in jection of strychnine. J. W. C. (Med. Review, May 21, '92).
Case in a woman, aged 21 years, who, two weeks after her confinement, was given. for headache, ounce of ace tanilid in bulk in an envelope, with directions to take a small quantity of it on the end of a teaspoon every two hours. The patient took two doses as directed. and a few hours afterward, the headache still persisting, she concluded that a very large dose would be more efficacious, and swallowed a teaspoonful of the drug. Half an hour later weak ness and dizziness, and an hour later she fainted and passed urine involuntarily. Later on she became cyanotic and semi conscious. The pulse was slow and ex tremely feeble, the respirations slow and shallow, the forehead bathed in sweat, and the face livid and perfectly expres sionless. The tongue, lips, and finger nails were intensely cyanotic and almost black; the head. hands, and eyelids were cold. but her feet were quite warm; temperature was normal; there was tingling of the skin over the entire body and some slight mental confusion. There was suppression of urine until noon the next day, and when passed it was of a dark-brown color and very abundant. Loud and continuous borborygmus noticed. The milk secreted by the breast was very much thinner than it had been before the poisoning-. The cyanosis lasted for several days. Treatment was that advised by Hare: Patient forced to maintain a recumbent position, the head kept low, and an hypodermic injection of aromatic spirit of ammonia, followed by sulphate of strychnine and sulphate of atropine, given. Hot bottles placed about the body, and grain of strychnine every three hours given by the mouth, alternating with whisky and aromatic spirit of ammonia. Owing to the condi tion of the milk, it was not considered wise for the patient to continue nursing her child, as the milk failed to return to its normal condition after recovery, and the patient was much exhausted. G. Baringer Slifer (Then Gaz., May 13, '97).