Case of an arthritic and hysterical woman, who took, for the mitigation of an attack of migraine, a cachet contain ing 4 grains of exalgin. This dose in a short time produced upon the skin and the mucous membrane of the anus and vagina a general papulose eruption, with patches of a fiery-red color, and, in cer tain spots, large blisters, containing a clear, serous fluid. The rash, which lasted four days, caused pain when pressure was applied, but it was not pruriginous. Linossier (Jour. de Pharm. et de Chim., No. 8, p. 413, '98).
Case of exalgin poisoning occurring in an adult male Chinaman. It was esti mated that the dose taken was 150 grains of Merck's preparation. The pa tient when seen was quite unconscious, intensely livid, with pin-point pupils and a full bounding pulse. His temperature was 100.G° F. Ire had vomited once. He was given 30 grains of salicylic acid by a nasal tube and V. grain of atropine hypodermically, and was put to bed. Two hours later he was given grain of atropine, and a few hours later a third dose consisting of Iwo grain. The urine contained albumin when first seen, but by the following morning the albu min had disappeared and the patient generally was much improved. Com plete recovery ensued. J. Bell (Lancet, Sept. 30, '99).
Treatment of Poisoning. — The first indication in the treatment of exalgin poisoning is to evacuate the stomach. Apomorphine in doses of to grain may be given hypodermically for this purpose. Cardiac and respiratory stimu lants (ether, strychnine, and caffeine by hypodermic injection, or strong coffee by the rectum) are then demanded. Morphine by injection may be given if there are convulsions or if much rigidity is present. If the respirations fail, arti ficial respiration should be kept up faith fully, and faradization of the phrenic nerve, stimulants, and warmth applied. In all cases of poisoning thus far re ported, these remedies have been success fully used.
Therapeutics.—Exalgin is essentially a remedy against pain, as its name indi cates. It is an antineuralgic, antirheu matic, and sedative. It should never be
given to patients suffering with any in terference of respiration nor used as a means of reducing temperature, for ex perience has shown that in febrile cases the untoward effects of the drug are marked.
Drug used extensively with marked success, in the alleviation of pain, and no disagreeable effects observed. It is unwise to employ the medicament, even in small doses, in patients convalescing from febrile disorders, owing to the weakened condition of the heart. D. Gair Braidwood (Brit. Med. Jour., Jan. 17, '91).
Satisfactory results obtained from the use of the drug as an analgesic in small doses. Arthur Conning Hartley (Lan cet, Mar. 7, '91).
Seven cases of various disorders, in which pain was prominent, were markedly relieved by exalgin, the dose of the drug being from 3 to 6 grains. Amelioration was comparatively prompt, and no disagreeable after-effects were observed. C. Ferreira (Med. Abstract, Mar., '91).
Used externally diluted, as a dusting powder, exalgin has been found to exert a slight anesthetic effect on painful ulcers, burns, and injured surfaces. Exalgin is used to relieve the pain of rheumatism, arthritis, the various forms of neuralgia, headaches, and the light ning pains of locomotor ataxia.
Comparatively large doses of this drug used in the treatment of various kinds of neuralgias, in the lightning pains of locomotor ataxia, and in those of rheu matism. Doses from 4 to 12 grains have produced no unpleasant symptoms, and when any occurred, such as cyanosis, the duration was short. In some cases as high a dose as 24 grains may be given without producing any cyanosis or other untoward effect. Desnos (Revue Gen. de Clin. et de Th0r., Feb. 15, '91).
Small night and morning doses (2 or 3 grains) have been found useful in many cases of epilepsy and chorea, but in these disorders medication must be continued for several weeks to be successful.
In all cases exalgin should be adminis tered in small doses until the suscepti bility of the patient is ascertained; thus only will dangerous symptoms be avoided.