nerves, the muscles and the sensory nerve terminations. It is especially depressant to the heart-muscle and the cardiac motor ganglia ; it combines with the red blood-corpuscles, lessening their oxidizing power, lowering the blood-pressure and reducing the body-temperature. Its taste is styptic and one of its earliest effects is the production of constriction of the fauces. It promotes waste and rapid excretion of waste-products, carbonic acid and urea being especially increased. Being eliminated by all the excretory organs, including the skin, it excites follicular inflammation at the points of elimination; resulting in an eruption which is papular at first, then becomes vesicular, and finally pustular, the pustules being umbilicated, like those of variola. This same eruption is also produced by the application of the drug to the skin with friction. Aphthous ulcerations, extending from the mouth to the stomach, with salivation and painful. deglutition, may also result from its continued use.

In small doses Tartar Emetic stimulates secretion in the bronchial and salivary glands, the stomach, intestinal canal, liver and pancreas. larger doses it excites nausea, vomiting and purging, with evacuations like the "rice-water discharges" of cholera, and great prostration of the vital powers. Toxic doses produce similar symptoms, besides epigastric pain, cyanosis, delirium, cramps, motor and sensory paralysis, suppression of urine and collapse,-much the same phenomena as observed in Asiatic cholera.

The SULPHIDE occurs native, and is the source from which the other compounds are prepared. It seems to be inert medicinally. SULPHURATED ANTIMONY owes its efficacy to the small quantity of the Oxide contained in it, and as this is variable, the action of the preparation is uncertain. The OXIDE has a similar action to that of Tartar Emetic, but being insoluble in water, it is of much less certain activity.

Antidotes and Antagonists.

Tannic Acid, or any substance containing it, is the antidote, forming the insoluble tannate. Opium, Alcohol, Ether, and other antispasmodics are physiological antagonists. Demulcent drinks should be freely administered to protect the mucous membranes. Alkalies and Salts of Lead decompose Tartar Emetic.

THERAPEUTICS.

TARTAR EMETIC was formerly much employed as an antiphlogistic on account of its power to cut short acute inflammations of sthenic type, and its use was very much abused, so that it has now gone out of fashion as a remedy. The contra-stimulant treatment of pneumonia and other inflammatory diseases by large doses of this salt after tolerance was established, is only worthy of reference as an historical fact. The same may be said of its external use as a counter-irritant as well as of its employment as an emetic, in both of which capacities it is too severe, while its emesis is too tardy in action to be of any value in poisoning. It is, however, a very

ANTIPYRINA.

105 efficient agent in many grave affections, if used in small doses (gr. ¿6-46); being highly recommended in acute inflammatory affections of the respiratory tract, especially pneumonia, broncho-pneumonia, acute cedema of the lungs, feverish and catarrhal colds, bronchitis, laryngitis and tonsillitis. In many respects it acts like Aconite in these and kindred affections, producing copious diaphoresis, slowing the pulse and allaying restlessness. It is considered a good remedy in puerperal peritonitis, mammitis and orchitis, in lumbago and other muscular rheumatisms, also in photophobia and in gastric indigestion after beer-drinking. In still smaller doses (gr. hourly) it is particularly efficient in catarrhal inflammations of the respiratory mucous membrane in children, accompanied by rattling breathing and much mucus, which is expelled with difficulty. Such cases often simulate asthma, the attacks being marked by cough, wheezing, and difficult respiration, also sibilant râles in the chest, and usually follow on severe colds or on measles. The Compound Syrup of Squill is commonly used as an expectorant and nauseant in the treatment of bronchitis and croup. The quantity of Tartar Emetic in it (gr. 34 to the 3) should be remembered in administering it to children. (See SCILLA.)

The OXIDE is chiefly employed in the form of James' Powder (Pulvis Antimonialis) for its mild diaphoretic qualities. The SULPHIDE is not used in medicine. SULPHURATED ANTIMONY is very uncertain in action and is but little used. The Compound Pill of Antimony (Plummer's Pill) was devised to obtain mercurial results without writing Hydrargyrum on a prescription.

ANTIPYRINA, Antipyrine, Dimethyl-phenyl-pyrazolon, Phenazone, C20H18N,O2 (Unofficial),—is a synthetical base, which forms salts analogous to those of Ammonium. It is a product of the destructive distillation of Coal-tar (compare CHINOLINA), and prepared by a patented and complicated process. It may also be obtained synthetically by heating Methyl-oxy-chinicine with Phenyl-hydracine, and collecting the powder. It occurs as a grayish or reddish-white crystalline powder, which combines with acids to form salts, is somewhat bitter, and soluble in onehalf its weight of hot water, and in its own weight of cold water; but is still more so if the water is acidulated with dilute nitro-hydrochloric acid. It is less soluble in alcohol, chloroform or ether, gives an intensely red color with Ferric Chloride, a beautiful green with Nitrous Acid, and a yellow color with Nitric Acid, which deepens to crimson on warming. It is not irritant to either the stomach or the tissues, and may be administered hypodermically.

Dose and Administration.

The full antipyretic dose for an adult was at first stated at 30 grains hourly for three hours, or 90 grains for the antipyretic effect. For children, gr. j for each year of age as a dose, to be repeated twice, or thrice, with the same intervals between each dose. That

such dosage was far too great, soon became evident from the many reports of alarming symptoms of collapse resulting in numerous instances; and the tendency has lately been towards a decreased size of dose at shorter intervals, which should be lengthened as soon as the drug-effects begin to be manifested. An average adult dose is now placed at 10 grains, for children grain per year of age between 2 and 5, 1⁄2 grain per year from 5 to 10; not exceeding 5 grains at a dose for any child under 15 years of age.

Antipyrine has but little flavor, is not unpleasant, and is therefore readily taken by children, in which respect it is greatly superior to Quinine. It may be administered in compressed tablets, each having from 1 to 5 grains;-or in Elixir Aurantii,- say gr. lxxx in iv, of which solution each 3 contains gr. ijss. If vomiting result, the same dose may be dissolved in half its weight of hot water, and injected hypodermically while warm.

Antagonists and Incompatibles.

Antipyrine may be decomposed when brought into contact with Nitrous compounds, a new and poisonous substance being supposed to be formed, of uncertain composition, but resembling the Anilin greens. The mixture of this drug with Spiritus Etheris Nitrosi is, therefore, highly dangerous, if this supposed reaction is at all likely to occur.

It is more or less decomposed or thrown out of solution by a large number of chemical compounds and other preparations, of which the following are the most important, viz. :—

Acid, Hydrocyanic Dil.

Acid, Tannic.
Butyl-chloral Hydrate.
Chloral Hydrate.
Cinchona, Decoction.
Cinchona, Fluid Extract.

Catechu, Infusion (conc.).
Ferrum, Sulphate.

Ferric Salts in Solution.
Hamamelis, Tincture.

Iodine, Tincture.

Arsenic and Mercury, Solution of

the Iodides of

Mercuric Chlor.

Naphthol 3 (solid).

Nitrites in solution (acid).

Sodium Bicarbonate.

Sodium Salicylate (solid).

Tinctures containing Tannin, Iron,

or Quinine.

Rose, Infusion.

Uvæ Ursi, Infusion.

Antipyrine and Phenyl-urethane liquefy when rubbed together.

Derivatives and Allied Compounds.

Antipyrine Salicylate, Salipyrin,—is the only salt of the base which has any therapeutic importance. It is a white, crystalline, odorless powder, very soluble in alcohol, insoluble in water. Its claims to preference are based upon its comparative harmlessness (3 ijss having been taken within 3 or 4 hours without the slightest ill effect); also its freedom from unpleasant after-results. Dose, gr. x-xxx every hour or 2 hours until

have been taken.

ij

Salipyrin has been employed with excellent results in acute and chronic rheumatism, rheumatic sciatica, neuralgia, and influenza. In rheumatic fever 15-grain doses are given at short intervals (11⁄2 hour to 1 hour), until about 3ij have been taken, continuing with smaller doses for a long time after convalescence, to prevent relapses. A dose of 8 grains is often sufficient against neuralgia. It was extensively used during the epidemic of influenza in 1891, and highly extolled for efficiency therein, as well as for its freedom from cardiac action. It is best administered in wafers as a powder, or in mixture, rubbed up with glycerin and flavored with raspberry syrup.

Hypnal is a combination of Antipyrine and Chloral, occurring as tasteless and odorless rhombic crystals, soluble in 6 of water, and credited with simultaneous action as a hypnotic and analgesic. Dose, gr. xv-xxx in aqueous mixture with some alcohol, flavored with syrup of orange. It is said to cause no gastric disturbance.

Although Chloral and Antipyrine are incompatible with each other, they form, when heated together, the above described compound, which resembles both and yet differs from each. Its chemical appellation is Tri-chloraldehyd-phenyl-dimethyl-pyrazolon, and its formula is C1Ch,N,H1503.

Antipyrine is a powerful antipyretic, a local anesthetic, and a general analgesic, and also possesses diaphoretic, mydriatic, antiseptic, disinfec

ANTIPYRINA.

107 tant, hemostatic and slightly hypnotic powers. After the ingestion of a full medicinal dose (gr. xxx), there is a stimulant stage of short duration, in which the heart's action is increased, and a subjective sense of heat is experienced, with flushing of the face. This is soon followed by profuse sweating, coldness of the surface, slowed pulse, considerable depression, and if fever be present by lowered temperature; the latter coming on within half an hour after taking the drug and its degree being in direct ratio to the quantity administered, as also its continuance, the former being usually from 3 to 5 degrees, and the latter from 1 to 10 hours, a fair average being about 2 hours. In one case a fall of 12° F. was observed.

When given with Kairine, the mixture of the two drugs has been found to produce a much greater fall of temperature, with longer continuance down, than that produced by an equal quantity of either drug given alone.

After the antipyretic effect of the dose has passed off, the temperature (in fever) commences to rise again,-the onset being usually preceded by a chill, which is of slight degree when compared with the severe rigors and dangerous depression occurring under the action of Kairine, Chinoline, and other members of the group.

In health its administration gives rise to slight nausea, singing in the ears, and a reduction of the body temperature of scarcely any extent, about 1° F. It slightly raises the arterial tension and blood-pressure ;sometimes (but seldom) induces vomiting, also a peculiar eruption on the skin; and (very rarely) such a degree of depression as to amount to collapse. It has no effect upon the respiration, but acts as a sedative upon the cerebrum, leaving behind a somewhat depressant influence on the brain. It dilates the pupils and is eliminated by the kidneys, appearing in the urine some three hours after its ingestion. The profuse sweating which it causes may be prevented by giving in advance a small dose of Atropine or Agaricine.

In toxic dose its principal influence is exerted upon the blood, altering the shape of the red corpuscles, separating the hematin, and causing decomposition of that fluid.

As an Antipyretic, Antipyrine, like Alcohol, acts by a double mode of operation,—(1) by diminishing oxidation, and (2) by promoting heatloss. The latter is attained by dilating the cutaneous vessels, allowing free radiation from the surface, and by the refrigerant action of the evaporation of the sweat.

As an Analgesic, Antipyrine has a very considerable degree of power, in common with all the Chinoline derivatives; but its property in this respect is found to act almost entirely upon pain due to manifestations of the rheumatic diathesis. In general anodyne action, it is not to be compared with the derivatives of Opium. Its hemostatic power is claimed to be superior to that of Ergotine.

THERAPEUTICS.

One of the most popular of the modern antipyretics, Antipyrine deserves its high rank in professional esteem, being the most certain and most powerful, though somewhat dangerous, and devoid of any other influence upon the course of any febrile disorder. Its principal applications are as follows, viz. :

In hyperpyrexia from any cause it is efficient. In acute rheumatism, it has held a high place as a remedy, for some time. In typhoid fever and other febrile conditions, wherein hyperpyrexia occurs, as phthisis, erysipelas, pleuritis, pneumonia, surgical fever, etc. In neuralgiæ, neuritis, and other painful affections, especially when of rheumatic origin,as lumbago, sciatica, hemicrania, supra-orbital neuralgia, etc., in which 10-grain doses are generally sufficient, and may be given hypodermically. In painful affections of hysterical persons ;-pain from cerebral tumors and from cardiac diseases,-also painful menstruation;-all of which are often relieved by it. In acute paroxysms of gout, a dose of 10 grains every two hours, preceded by a commencing dose of 25 grains, promptly relieved the pain and shortened the duration of the attack in one very thoroughly observed and carefully reported case. In chronic gout, very remarkable results are reported from the use of this agent, indicating a specific action thereon of curative character.

It has seemed to render efficient service in dysmenorrhoea, carbuncle, and cerebro-spinal meningitis; and affords valuable aid in the pyrexia of intermittents, in which stage the slow action of Quinine prevents its availability for immediate relief.

It has rendered signal service in the diarrhoea of children, given in doses of gr. ss to gr. jss; also in the urticaria-like eruptions of children its action when administered internally has been so promptly efficient as to indicate for it a direct influence upon the vascular nerves. As a symptomatic remedy against itching it is equally efficient in nervous pruritus, true prurigo, urticaria, erythema, pemphigus vulgaris, and lichen ruber. As an antigalactagogue 4-grain doses every two hours have proven highly efficacious. It is successfully employed against whooping-cough, chorea, bronchial asthma, and sea-sickness.

For the purpose of relieving pain, the conjoint administration of Antipyrine and Morphine is said to be much more efficient than the use of either agent alone.

APIOL (Unofficial),—is a non-volatile, oily liquid, of acid reaction and pungent taste, soluble in alcohol, ether, chloroform, and in glacial acetic acid. It is extracted from the fruit of Petroselinum sativum (Parsley), a biennial plant of the nat. ord. Umbelliferæ, which also contains a gelatinous substance named Apiin, and a Volatile Oil which is by some