Amylene-hydrate Poisoning. — Un toward effects were noted by Dietz. In four instances a large overdose was given through neglect to shake the bottle in which the drug was mixed with syrup; deep sleep followed, from which the pa tients could not be aroused. There was total paralysis and suppression of tactile sensibility, including that of pain, and of corneal reflex. The pupils were dilated, and reacted but slowly to light. Res piration was retarded, superficial, and irregular; the pulse small, soft, and slow: the temperature lowered in two eases to 95° F. Artificial respiration was required in the case of one patient. During re covery there were confusion of ideas and inco-ordination of bodily movements. The author likens the toxic effect to that produced by alcohol. He advises that to avoid such accidents the drug be admin istered in capsules.
Therapeutics.—Amyl-hydrate is justly considered by the majority of observers as an excellent hypnotic. It may be ad ministered during long periods, owing to a quality not possessed by chloral: i.e., it does not tend to increase nitrog enous waste.
Experiments showing that the action of amylene-hydrate is entirely opposite to that of chloral-hydrate, the latter in creasing the quantity of nitrogen elimi nated by the urine, the former lessening it about two grammes. That excreted by the fteces showed no change. Amy lene-hydrate, therefore, prevents the de struction of albuminous substances, and it is preferable as a narcotic to chloral hydrate whenever the hypnotic effects are to be continued for a long time, and in all affections in which there is an exaggerated decomposition of albumi noids; fever, more or less intense; very pronounced dysprnea; anannia and hectic diseases, especially pulmonary phthisis and diabetes; and also cases of digestive troubles with concomitant anorexia. J. Peiser (Fortschritte der Med., No. 1, '93).
It is especially in the insomnia of mental disorders that it has been em ployed. Headache sometimes follows its use.
It acts especially well in insomnia resulting from nervousness, excessive mental exertion, anemia, fevers, cardiac diseases, insanity, and after the with drawal of narcotics that have been con stantly used. It is contra-indicated in
insomnia from pain, cough, and fre quently in cardiac and ummic dyspncea, and in gastric disorders attended with irritation or nausea, but in such cases its administration by the rectum is followed by the usual beneficial results. Many patients and children do not tolerate it on account of its taste and odor, but it is readily taken when administered in soft capsules. Unusual effects are pro duced only by large quantities, and con sist in loss of reflexes, paralysis of ex tremities, mydriasis, low temperature, feeble pulse, and shallow respiration. No cases have been observed in which an amylene-hydrate habit was engendered, • or a cachexia developed, due to the rem edy. (W. H. Flint.) To produce sleep in the above dis orders it may be administered by the mouth or by enema with gym arabic and water. Unlike chloral, it has no irritative action on the mucous mem brane of the rectum. Sleep comes on after fifteen to forty-five minutes, though often sooner, and occasionally no effect at all is produced. On the whole, it is a reliable hypnotic, if given in sufficient dose: two to three times as large as that of chloral, though it is somewhat less certain in its effects than is this substance or morphine. Unpleasant secondary ef fects, as excitement or slight drunken like stupor, are very seldom witnessed. It does not lose its efficiency,—though given during three months in some cases, —and the deep and refreshing sleep is praised by the patient oftener than in the case of any other hypnotic. The drug is more powerful than paraldehyde or urethan, and is to be preferred to them. It should always be chosen in heart disease in place of chloral, though it is not so strong as the latter. It is fully equal to sulphonal, and, indeed, superior to it in many respects. Three capsules, each containing 15 minims, are easily taken on retiring, and will almost certainly produce sleep. The effect fol lows much more promptly than after sulphonal, and it has not the same tend ency to produce sleepiness and giddiness on the following day. (E. Kirby and J. P. C. Griffith.)