Case of an infant, 16 days old, suffer ing from haemorrhage from the umbilicus. A powder of equal parts of boric acid and acetanilid applied locally twice daily for three days caused the face to become distinctly cyanotic; the lips, ears, finger tips, and toes bluish; the hands and feet cold; the breathing bordering upon ster tor. The condition disappeared on ceas ing the application of the powder. R. C. Rosenberger (Phila. Polyclinic, No. 45, '95).
Case in an infant, aged 14 months, in whom excision of the hip had been per formed for tuberculosis and the wound packed with acetanilid. In four hours the temperature dropped five degrees and there were great pallor and feeble pulse. The temperature rose and symp toms disappeared upon removal of the dressing. The second case was one of extensive suppurative superficial scald. At twelve o'clock 2 drachms of finely powdered acetanilid were dusted over the surface; at five o'clock the patient pre sented grave toxic symptoms; all ace tanilid was at once removed, digitalis and whisky were exhibited, and by mid night he was in a normal condition. T. S. K. Morton (Phila. Polyclinic. Feb., '95).
Case of eczema in which dusting powder. composed of 1 part acetanilid and 3 parts subnitrate of bismuth, was used three times a day. When it became necessary to secure a new supply, the second application produced alarming cyanosis, with labored breathing and other evidences of distress; discontinu ance of the powder. Inquiry showed that cyanosis had followed every appli cation of the powder. Charles Sauter (Louisville Med. Monthly, Nov., '95).
Two cases: an amputation of the ear for epithelioma of the helix and an abscess of the maxillary sinus in elderly men, the one aged 73 and the other S4. Acetanilid seemed to produce a great deal of irritation and to delay granula tion; similar experience several times with iodoform. William A. Edwards (Pacific Record, Jan. 15, '96).
Marked instance in an infant in which it had been applied to the navel. Face, lips, fingers, toes, and the whole of the skin and visible mucosa of a dark-blue color. Rectal temperature was 99° F.; respiration, 60. Oxygen, whisky, and digitalis were administered. No effect upon cyanosis noticed from the oxygen inhalations. Not until the fourth day did the child regain its former strength and disposition. I. M. Snow (Archives
of Pediatrics, June, '97).
In obstetrics acetanilid used as an antiseptic in all injuries occurring in the course of the three thousand eases seen by her since 1894. It always caused rapid resolution of the wound without suppuration. It also exerted a distinct analgesic action, which was particularly noticeable in the painful tears in the re gion of the clitoris, the urethra, and the vulva. Prokopieff (Yratch, xxi, No. 14, 1900).
While acetanilid forms an excellent dressing for wounds, burns, and exposed surfaces in general, it is easily absorbed by the latter, and may thus give rise to active toxic symptoms, especially in in fants, as shown above.
The following combination recom mended in numerous diseases, applied in the form of a powder or a paste: 3 Acetanilid, 3j.
Zinc oxide, 3iij.
Iodized starch (5 per cent.), 3iv.
The iodized starch should be properly prepared and the acctanilid finely pul verized. Sufficient water is added to make a paint or paste, to be applied with a stiff brush. Liquid albolene, ben zoin, or olive-oil may be used instead of water when the application is in tended for dry surfaces or ulcers; a gauze bandage may be used to prevent it from being rubbed off. When dry the powder is of light-drab color, when wet of a slate color, but when in con tact with pus it turns white, showing that the iodine has been liberated. This combination of the drugs gives an antiseptic, astringent, soothing, and protective remedy, having remarkable healing properties, useful in eczema. ulcers, dermatitis from all causes, in cluding superficial burns, impetigo, sy cosis, herpes zoster, and chancroids. T. G. Lusk (Jour. of Cutaneous and Genito twin. Dis., Dec.. 1901).
Treatment of Acetanilid Poisoning.— In the treatment of poisoning by acetan ilid cardiac, respiratory, and vasomotor stimulation is of great importance. Ether, hypodermically, has been most frequently used. Belladonna is probably the best drug to fulfill the indications; it tends to equalize the blood-pressure, and with external warmth and some more direct cardiac stimulant—brandy, etc.— presents the needed qualities for antago nizing the overaction of acetanilid. Therapeutics.