Case of a young man who had often taken antipyrine without discomfort until he was 17 years of age, when he suffered from typhoid fever, and devel oped marked intoleranc to this drug. In the course of the following year he took it several times, once a dose of 15 grains, afterward half this dose, then only 3 or 4 grains, and finally between 1 and 2 grains. Even after the smallest dose unpleasant symptoms appeared. At first there were marked twitehings in the genital and anal regions. In a few days there appeared here numerous blebs, which burst and formed scabs. On the gains there appeared also little blisters. The remarkable fact in this ease is that intolerance developed after typhoid fever. (Jour. de Med. et de Chin, Dec. 25, '96.) A review of cases in which dangerous symptoms or death had followed sug gests that antipyrine should not be given in antipyretic doses to fever patients, because it interferes with the action of the kidneys, and that in febrile conditions complicated by nephritis (pneumonia, typhoid fever, tuberculosis, etc.) it is contra-indicated. It must be avoided in true angina pectoris, because it acts in juriously on the heart-muscle, and there is always danger of cardiac dilatation in this affection. In the neuralgic form of angina pectoris there is no reason for preferring its hypodermic use to that of morphine. Weakness of the circulation, too, is a contra-indication to antipyrine. (Eloy.) Warning against its employment in all cases in \ v i ell the kidneys are dis eased, since its elimination is interfered with, and toxic effects might arise. Ar teriosclerosis should not be treated by it., even when the kidneys are not affected. Huchard (Jour. Amer. Met!. Assoc., July 7, 'SS).
Contra-indications for the employment of antipyrine: a weak heart; diphtheria, with phenomena of rnyocarditis; profuse luemorrhages; in debilitated subjects; convalescence from chronic fevers; and the night-sweats of tuberculous patients.
B. Martin (L'Union Med., Oct. 20, 22, 27, '91).
Persons suffering from erysipelas seem to be peculiarly susceptible to antipyrine. It usually causes anuria and a profound fall of temperature, requiring caffeine and hot applications. Erysipelas is one of the infectious disease^ in which anti pyrine is contra-indicated. Spanoudis (L'Abeille Med., Mar. 27, '97).
Antipyrine should never be prescribed for very old people, for subjects attacked with non-compensating cardiac lesions, or for those in an adynamic condition. In influenza and erysipelas it should always be associated with quinine, and, in convalescence, with strychnine or caf feine. In arthritic subjects, who are nearly always dyspeptics, it should be associated with an alkali (sodium bi carbonate or sodium benzoate) and pre scribed in solution. If it cannot be taken except in a capsule, the patient should drink a quarter or half a glass of Vichy immediately after taking the capsule.
In tuberculous subjects 12 grains at a time should not be exceeded, and the condition of defervescen:e should be care fully watched. It is well, in this case, to combine alcohol and antipyrine and give the latter in solution. In diabetic subjects the association with alkalies is obligatory. In children antipyrine may be administered without inconvenience even in amounts proportionately larger than in adults, provided it is given in divided doses. This tolerance depends as much upon the integrity of the renal function as upon the mode of adminis tration, which should nearly always be by the solution. M. V. Cl6ment (Gaz. Heb. de Med. et de Chir., Sept. 26, '97).
Antipyrine intoxication after the in gestion of 15 grains in the form of mi grainin. The symptoms were dryness in the mouth, painful redness and swelling of the fingers, vesicles on hard palate, salivation, purpuric eruption on legs, ec zema of scrotum, oedema and vesicles of lower lips, cedema of prepuce. fever, and rapid pulse. G. Graul (Dent. med. Woch., Jan. 19, '99).
Three cases of a remarkable eruption caused by antipyrine. This eruption con sists of dark blotches in the skin of the penis, sometimes accompanied by oedema. In one ease the eruption appeared four and a half hours after the first dose was taken. The patients were alarmed, think ing that gangrene of the penis was going to follow. Fournier (Ann. de Derm. et de Syph., Apr., '99).
Physiological Action, — Antipyrine is excreted by the kidneys, and may be found unchanged in the urine. Perret and Givre have shown that, no matter what the age of the person may be, elimination by the urinary tract begins at the same time, varying from three fourths of an hour to an hour. They found, however, that the elimination is finished sooner in the child than in the adult, and likewise in the adult than in old age. The conditions causing accumu lation in the system do not influence in any manner the time of the appearance of antipyrine in the urine, but notably increases its duration. Any of the sub stances producing coloration when added to aqueous solutions may be used as a test to detect the presence of antipyrine in the urine, but ferric chloride is most generally employed for the purpose, de tecting antipyrine in dilutions as high as 1 to 100,000.
The eliminaticn of antipyrine when given by the rectum occurs from the mucous membrane of the stomach, in from one-fourth to one-half hour before taking place by the kidneys. P. Kandi doff (Wratsch, No. 13. '93).
Antipyrine appears in the urine minutes after its ingestion by the stom ach and thirty minutes after its intro duction by the rectum. Lamanski and Main (Le Bull. Med., Jan. 29, '93).
Antipyrine may be excreted from the rectum, the mouth, or from the subcuta neous connective tissue when given by hypodermic injections.