Case of poisoning by antipyrine. Within a quarter of an hour after tak ing a dose of 10 grains the patient felt very ill. His face was cyanosed, his lips and nose swollen and blue, and his eyes almost closed from swelling of the eye lids; skin was cold and clammy; sweat ing; pulse, 128, very weak, small, and compressible. Pupils widely dilated. Administered 5 grains of carbonate of ammonia, grain of digitaline. grain of strychnine, and ounce of vinnin aurantii. The next quarter of an hour his condition improved as far as the symptoms of cardiac depression were concerned. Recovery. IL W. McCaully Hayes (Brit. lied. Jour., Feb. 1, '96).
Case of an anaemic girl of 19, who took a draught containing 5 grains of anti pyrine and 7 grains of bromide of potas sium, with a drachm of compound spirit of ammonia. Toxic symptoms appeared about ten minutes after the draught was taken. A few minutes later the follow ing conditions were present: Cold shiv ers, severe and gasping dyspncea; the face was swollen, especially about the eyes, so much so as to prevent any possibility of opening them or of seeing, except with great difficulty, the pupil; and the body was covered with a bright-red rash, like scarlet fever, resembling that of urticaria, so that it presented wheals, which were of different sizes: from that of a small papule to some as large as five-shilling pieces. The temperature in the axilla was 97° F., and the pulse, which was very intermittent, was only 50. She complained of no pain. The tongue was very dry. The lips and gen eral aspect were decidedly cyanotic. Stimulants, with strychnine and digitalis, were given. The shivering passed off in about three hours, but the other symp toms continued for about eight, hours. The rash did not disappear for thirty hours. E. Webster (Lancet, Jan. 30, '97).
Poisoning by antipyrine in a aged woman, convalescent from typho nialarial fever. After taking 10 grains of antipyrine, 20 minims of spiritus am nioniw aromaticus, and 1 ounce of water, she was very pale, but not cyanotic; no of the eyelids, but almost com plete loss of sight; rash, which disap peared in about eighteen hours, resem bling that of urticaria. Patient rallied well on the administration of hot coffee and whisky. Recovery. F. G. Wallace (Lancet, Feb. G, '97).
Case of a woman, aged 50 years, poi soned by 7 grains. After an hour: swell ing and redness of the upper lip. After three hours: pain in the eyes; paralysis, swelling. and smarting of the tongue. Speech difficult; salivation. An hour later: chilliness, sensations of heat; and, later, syncope. vomiting, and diarrhoea.
The next morning there was an eruption upon the face, arms, hands, and thighs which resembled scarlet fever, with marked burning and itching about anus and vulva that gradually extended over the whole body. These symptoms grad
ually disappeared in two weeks. Severe desquamation. Scheel (Then Monat., H. 3, S. 101, '97).
Case showing that antipyrine may un expectedly prove poisonous in a small dose grains, in this instance) in a person who has shown no special idiosyn crasy toward it, after taking the drug on many previous occasions. Eisenmann (Ther. Monat., Apr., '97).
Case in which a dose of 10 grains of antipyrine caused acute pain in the ab domen, emesis, and rapid swelling of the face, almost closing the eyes. This was followed by two periods of collapse, one lasting a half-hour. Recovery followed. The patient had taken similar doses be fore with no ill effect. H. Blakeney (Brit. Med. Jour., July 8,'99).
The toxic action of antipyrine on the blood seems to be a transformation of its oxylnemoglobin into methtemoglobin.
The action of antipyretics on the blood when administered in toxic doses may be summed up as a transformation of oxylnemoglobin into methmmoglobin. A phase of anmmia, or diminution of oxy hmmoglobin, precedes the accumulation of methmmoglobin. In this period there is at the same time production and elimi nation of methaumoglobin; if elimination be hindered or transformation be too rapid, phenomena of cyanosis may be produced which must be distinguished from those of the period of intoxication. IRmocque (La Semaine Med., Mar. 27, '95).
Blood of frogs and blood taken from the cyanosed lips and other parts of a rabbit, both ante- and post- mortem, ex amined spectroscopically. The rabbit had died from toxic effects of antipyrine, yet the spectrum of metheemoglobin was certainly not present. Andres IIalliday (Montreal Med. Jour., July, '97).
The poisonous effects of antipyrine upon the nervous system have been studied by Langlois and Guiband. By graduated doses, given to animals whose spinal cord had been divided below the medulla oblongata, they discovered sev eral stages of antipyrine poisoning. First, a cerebral stage, in which clonic epilepti form convulsions arc limited to the head; second, a cerebro-spinal stage, in which the head is still affected with clonic con vulsions, while the trunk is attacked with one or more tonic spasms (opisthotonos); third, a cerebral stage, with spinal hyper irritability, in which the shocks caused by the clonic convulsions of the head set up violent reflex movements of the body, comparable to the spasms of strychnine poisoning; fourth, the reflexes of the head disappear at the same time as those of the trunk. Antipyrine has, then, an elective action in the higher centres, and this explains why its sedative action is more marked in head affections than in spinal.