The blood examined the day after the poisoning did not present anything abnormal so far as the configuration of the red globules were concerned; enumeration 4,200,000. The temperature on the same day was 99.6x. The urine of the first day contained A. still unchanged; there was no trace of it in the m., and its alkalinity was due to the carbonate of ammonia. (MERKLEN, Medorrhinum Contemp., 1885.)
4. Mrs. W -, aet. 64, took a teacupful of an acetous solution of A. She had intense burning pain in head and at stomach after swallowing it, and “could not get her breath.” She took salt and were, but did not vomit till 8 hours afterwards, when violent emesis and purgation set in, and continued until I saw her, when she vomited stringy mucus mixed with blood. She was almost exhausted; extremities were icy cold, and head cold and clammy; intense pain on pressure over abdomen, which was hard and enlarged; tongue pallid in centre, and very smooth and red at tip and edges; eyes injected; lower lids puffed; she complained of burning pain in eyes, and said, “Oh! my head will burst; ” pulse hard, 84; temp. normal; resp. laboured, 44. (ALLEN’S Encyclopaedia, x, 299.)
5. H. C -, aet. 23, sent for me Oct. 5th, 1886. He was in a state of partial collapse, sweating, and almost pulseless. He had vomited, and had severe diarrhoea, not in any way characteristic. He had been subject to dysentery abroad, and had been drinking on the 2nd. I gave him a stimulant stomachic, with 2 gr. of gray, and 5 of Dover’s powder, every 4 h. On seeing him next m., I found that he had revived, and had been sick after every powder, vomiting some blue liquid, unfortunately thrown away. He now showed me an indelible aniline pencil, which he had used on the 3rd to push out a fang of a tooth left after partial extraction on the 1st. On the same day he was seized with vomiting and purging, and just before I saw him was said to have had an epileptic fit. He recovered in a few day, only some weakness remaining. (PEARSE, Brit. Medorrhinum Journ., Oct. 23rd. 1886.)
6. Chronic poisoning by A., as observed in workmen in the aniline factories, has been described by Charvet, Laboulbene, and Bergeron.
6 a. CHARVET speaks of general nervous symptoms – vertigo, stupidity, muscular cramps and weakness in extremities, hyperaesthesia, anaesthesia, and neuralgic pains, occurring epidemically along with gastric symptoms, and disappearing on removal from the poisonous atmosphere without any other treatment. (Ann. d’ Hyg. publ., Oct., 1863.)
6 b. LABOULBENE speaks of a workman who after two months began to complain of pain in penis and scrotum; these part became swollen, and remained so for some time. One month after this he began to lose sexual power, and complained also of bitter taste in mouth and vertigo. The eyes were irritated. (N. r. Medorrhinum Record, xi, 382.)
6 c. BERGERON speaks of hebetude, somnolence, vertigo, weakness; sometimes epileptiform attacks, tetanic spasms, &c. In the end the workmen fall into a condition of profound anaemia, with discoloration of skin, lilac tint of lips, anorexia, gastric disturbances, &c. (Ibid.)
7 LAILLER, in two cases, saw poisoning follow application of the hydrochlorate to patches of psoriasis.
7 a. In the first case a 10 per cent. solution caused, in 1.1/2 hours, vomiting, repeated 10 – 15 times during night; incontinence of urine, with a little tenesmus; n. restless; next m. face and nearly whole body cyanotic; pulse 116, small, regular; slight rales in chest; severe pains in heels and calves. A later application of a 5 per cent. sol. caused, in 2 hours, headache, irresistible drowsiness, coldness, and dyspnoea; cyanosis very marked; voice very feeble.
7 b. In the other a 2 per cent. sol. caused, in 4 hours, loss of consciousness, lasting 5 m.; deep cyanosis for 5 hours, followed by great pallor and cold sweats; resp. normal. Following n. was sleepless; urine highcoloured. (Union Medorrhinum, 1873, No. 67.).
Experiments on animals.
1. The experiments of Schuchardt, Bergmann, and Sonnenkalb leave no doubt on the point that, both in cold – and in warm – blooded animals, this poison acts like other narcotics, by altering the functions of the brain and spinal cord. Muscular contractions and general convulsions, anaesthesia and paralysis of motion, are the symptoms thus caused. The excitability of the peripheral motor nerves, as well as of the muscles, remains intact. The action of the heart is only disturbed in a secondary manner, that is, in consequence of the affection of the blood induced by the paralysis. Experiments on frogs show that A. is not a poison to the heart. The question whether it exerts any special or specific influence on the nervous centres for respiratory movements has not yet been solved by any experiments which have been made, although they have proved that aniline death, in warm – blooded animals, happens through asphyxia. (ZIEMSSEN’S Cyclopaedia, xvii, 521.)
ANTIFEBRINUM.
Introduction
Antifebrinum, acetanilid, formed from aniline, C6H5NHC2H2O; with its derivatives, methylacetanilid (exalgine) and monobromacetanilid.
Poisonings
1. A student with catarrh took antifebrin in repeated doses till he had consumed almost 30 grm. He gradually began to manifest symptoms of aniline poisoning; and, although the most prominent symptoms were absent, he complained of inability to sleep, and cardiac palpitation and dyspnoea produced a feeling as of impending death. The characteristic blueness of skin was general over the whole surface, but especially dark on eyelids, chin, and temporal regions. There was no puffiness of face, and the general appearance was quite different from that of cyanosis. On the 3rd day patient was able to leave his bed, and the blue colour had entirely vanished. (Chemist and Druggist, May 31st, 1890.)
2. A healthy young married woman took about a teaspoonful in water, to relieve a headache. Ten m. later she took a similar dose, when, fearing she had overdone it, she took some milk and alum water, and vomited; but immediately afterwards giddiness, singing in ears, throbbing in temples, and dull pain in head, together with feeling of weakness, came on, and face assumed a livid hue. Four hours later face was livid, lips blue, and pupils contracted; but heart, temperature and mental condition were normal. An aperient and stimulant were ordered. Shortly afterwards she became suddenly collapsed, pulse could not be counted, breathing shallow. Stimulants were injected, and in 3 hours she somewhat recovered, when collapse returned; and then an intravenous injection of common salt seemed to act most beneficially. In about 14 hours she was out of danger, but complained of debility and pain in her limbs for a week. ( Lancet, May 24th, 1890.)
3. A girl, aet. 24, took exalgine to subdue the pains of myelitis – for 5 day 2 gr., for 2 day 4 gr., and finally for 7 day 6 gr., 3 times a d. No relief was given to pain, but after the 14 day symptoms of poisoning occurred. The first symptoms noticed were blueness of lips and cheeks, and small compressible pulse; she felt sick and giddy, sight was indistinct, and there was feeling of weight at epigastrium. Amyl nitrite was given by inhalation, but this increased the cyanosis. After 5 hours patient vomited, followed by still further increase of cyanosis and delirium, with frothy salivation. Temp. rose to 99.8x, pulse to 144, small and compressible, but regular. She was treated by stimulants, strychnia and digitalis, and in 4 – 5 hours more symptoms had passed off, save slight cyanosis. (Brit. Medorrhinum Journ., Feb. 8th, 1890.)
4. To relieve a severe pain in lumbo – sacral region, a medical man took a gr. of exalgine at 9:30 p. m., and 3/4 hours later 2 gr. more in a little whiskey. Shortly afterwards he complained of a little giddiness, and several times said that his head felt so large it seemed to occupy the whole room. He continued, however, playing cards till 11, when without warning he collapsed in his arm – chair, prostrate, quite unable to speak or more, and gasping for breath. He continued in this state for over 1/2 hours, when he got slightly better, and said a few words between his gasps; he said he was not strong enough to move, and felt each breath a fearful effort. In this condition he was carried up to his bedroom and laid down; but feeling unable to breathe lying down, was placed in an arm – chair well covered up before the fire. His respirations became painful to witness; he seized and clenched the hands to those around him, and was in many respects just like a man suffering from a bad attack of asthma. Resp. was 38, gasping and shallow; pulse quiet, rather weak; surface very cold, face pale but not cyanosed. Was relieved in 2 hours after vomiting a little whiskey, but remained sick, giddy and weak, and for an hours suffered from frequent and painful strangury. He then got to bed and slept well, and left for Scarborough the next m. The day following he was slightly jaundiced. During the paroxysm he felt no pain, but numbness all over, and as though diaphragm had stopped working, and he must go on breathing on his own account at any cost. He is not at all subject to asthma. (Ibid., May 3rd.)
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.