Treatment of Poisoning by Piperazin. the case mentioned by Slaughter cardiac and respiratory stimulants were administered. External heat was ap plied to the limbs and trunk, and the lower limbs were elevated. A high, stimulating rectal injection was adminis tered and the patient was catheterized. The paralytic symptoms (paraplegia) were treated with large doses of strych nine. The patient fully recovered.
Therapeutics. — Piperazin was intro duced as a solvent of uric acid. It has been found an effective remedy in vari ous manifestations of the uric-acid di athesis. Renal and vesical calculi, due to the deposit of uric acid, have been disintegrated and expelled through the use of piperazin. It has been given with the idea of preventing the formation of renal and vesical calculi. It is useful in irritation and inflammation of the bladder arising from an excess of uric acid in the urine. For this purpose it may be given internally, or the bladder may be irrigated with a 1-per-cent. so lution.
It has been used in diabetes and has been found especially useful when asso ciated with gout. It has been found beneficial in renal colic and in Immor rhage from the urinary passages.
Piperazin has little effect in lessening the acidity of the urine, but causes a marked diminution in the amount of crystalline urates. The drug employed in doses of I5 to 3I grains a clay, in 5 cases of gout, seemed to possess no more energetic powers than the ordinary alkaline waters. Mordhorst (Les Nouv. Rem., May S, '92).
In the uric-acid diathesis piperazin must be administered continuously for a fortnight before an opinion can be formed: 1. Diuresis is considerably in creased, the urine passed in a case of arthritis having been doubled. 2. Spe cific gravity of the urine lowered, but it never becomes alkaline or even neutral. 3. The appetite is not affected, and no disturbance of the general condition has been observed. The hydrochloric salt of piperazin is better than free base product, being less hygroscopical. Witt zack (Notes on New Remedies, Mar., '93).
Case of excruciating renal colic in a woman, the attacks recurring two or three times every month. The usual treatment by mineral waters and careful dieting utterly failed. Internal adminis tration of piperazin in the daily dose of grains was tried. Attacks became
mild, while the urine assumed a peculiar reddish color (due to the presence of urate of piperazin). During one such attack the patient voided with her urine a brownish, corroded, small-sized stone, after which the reddish tint became nearly imperceptible, and then disap peared altogether. Shortly afterward the attacks ceased, and up to the time of the report—a year and a half—had not recurred. Egoroff (Bolnitch. gaz. Botkina, No. 34, '94).
Piperazin extensively used. No toxic symptoms of any sort have ever been ob served from a moderate dose, as of drachm daily, although the drug has been ccntinued for long periods of time. The limit of tolerance seems to be about 1 drachm daily. It was found in ex periments that the two different makes of basic piperazin on the market (neither of which, by the way, is Merck's) dif fered from each other quite markedly in degree of tonicity. This difference was ascertained to be due to a matter of con centration of the drug in the more toxic: i.e., to a much smaller amount of water of crystallization. It is on account of this that a stable salt of piperazin is pref erable for administration to the basic piperazin still so much used. D. D. Stewart (Med. News, Mar. 28, '90).
A solution in alcohol and water has been applied locally to gouty joints and swellings. Ritter advises the tion of piperazin and phenocoll for the relief of gout. Piperazin in 2-per-cent.
solution has been injected ally, in amounts equal to 3 grains a day, for the relief of lumbago and gouty manifestations. These injections gave rise to pain, but did not cause abscesses (Heubach). Other observers have wit nessed the formation of abscesses after such use and condemn it.
Allied Substances.—LYCETOL.—This is also known as dimethyl-piperazin tartrate; it is claimed that this stance is superior to piperazin, as the tartaric acid is supposed to be converted into carbonic acid, alkalizing the blood, and dissolving uric acid. It occurs in a fine, granular, white powder, and is soluble in water. It has a diuretic effect, an agreeable taste, and is non-hygro scopical. It may be used in gout in daily doses of 15 to 30 grains.