On two cases of poisoning by anilides (exalgine and antifibrin) / by T. Jessopp Bokenham and E. Lloyd Jones.

  • Bokenham, T. Jessopp.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: On two cases of poisoning by anilides (exalgine and antifibrin) / by T. Jessopp Bokenham and E. Lloyd Jones. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted for the AuthorB from thebj^^ Medical Journal, Feb. 8/ ON TWO CASEsNMV^OISOMN.ef BY ANILIDES By T. JESSOPP BOKENHAM, M.R.O.S , L.R.C.P., L.S.A., AND E. LLOYD JONES, M.B., B.C.(Oamb.). Considering the large number of artificial drugs which have re- cently come into general use, and the imperfect state of our knowledge as regards their exact physiological action, it is some- what surprisiag that more mishaps have not occurred as a con- sequence of their use. Although acetaniHde (antifebrin), antipyxia, and similar drugs are very largely prescribed, and are even used by patients on their own responsibility, yet there seems, judging from the English journals, to have been a con- siderable immunity from alarming toxic effects. This being the case, we feel that no apology is needed for recording the two following cases. Case i.—M. L., a girl, aged 24 years, had myelitis, with great pain in the back and limbs. There was no elevation of tempera- ture. On June 3rd it was decided to give exalgrne (methylacet- anilide) with a view of relieving the pain. From this date rmtU June 8th the drug was given in doses of gr. ij ter die. The dose was then doubled, but as even this amount failed to give relief it was further increased on June 10th to gr. vj ter die, and con- tinued until Jime 17th, when sjrmptoms of poisoning first set in. At 10.30 A.M. on the 17th the hps and cheeks were noticed to be blue, the pulse was smaU and compressible, but not rapid; tem- perature being normal. Though there were no very urgent symptoms the drug was discontinued, and brandy 3ij was ordered every hour. The patient stated that the medicine made her feel sick and giddy, that her sight was indistinct, and that there was a feeling of weight at the epigastrium. At 3.80 p.m. a few inhalations of amyl nitrite were given; this considerably emphasised the blueness, and caused marked dilatation of the vessels. It was thus evident that the whole of the circulating blood was profoundly changed. The cyanosis continued to mcrease, and at 3.46 p.m. the patient vomited, after which it became still more marked. At 4.10 p.m. her nails, hps, and cheeks were deeply cyanosed; frothy sahva was escaping from her mouth; she was delirious, and appeared to recognise no one. Her feet were not blue nor cold. Temperature 99.8° F.; pulse 144, very small, regiUar, compressible. The amount of stimulant was increased, and hq. strychnine mij given hypodermically, a mixture contaimng tinct. digitahs mx being also given by the 1 Read in the Section of Pharmacology and Therapeutics at the Annual Meet- ing of the British Medical Association, held in Leeds.