Introduction
Phenazon (Phenyl – dimethyl – pyrazolon), C11H12N2O. A product of coal – tar through toluidine.
Poisonings
1 a. Two years ago I made a communication to the Academy of Medicine based upon a case occurring in my practice, where most disagreeable effects had followed the administration of A. I quoted two other unpublished cases that had been related to me, and three published cases from English and American periodicals. In the 6 cases the symptoms noted from English and American periodicals. In other 6 cases the symptoms noted were: Three times swelling of eyelids to such an extent that eyes were almost closed, and of face so that features were scarcely recognisable. Once swelling was chiefly located in throat, and threatened asphyxia. Five times there was a rash of some kind, generally erythema or urticaria, with troublesome itching. In one case where there was urticaria there was loss of consciousness, which was immediately restored by the hypodermic injection of atropia. In two cases buzzing of ears was noticed. In two also there was violent gastric pain, followed by gastro – enteritis lasting six weeks, it being several more. before patient entirely recovered. Once there was profound mental disturbance, patient being afraid of becoming insane; and the mental equilibrium did not return entirely for some one. Hypersecretion, in the shape of running from nose and eyes and excessive perspiration, was noted several times; and once patient felt as though she was stuffed with ice.
1 b. What I wish to point out now is that I find the symptoms put down to the prevailing influenza are in many cases those described in my paper as due to overdoses of antipyrin, particularly swelling of the eyes, urticaria, and watery discharges. The extensive use f the drug in its treatment is well known. In one case which has come to my knowledge I have no doubt of its having caused death. The patient, an elderly lady, had been treating herself. The symptoms had consisted of cough; a dusky eruption on the body, which appeared swollen; profuse perspiration; troublesome itching and urticaria, chiefly between the fingers; swelling of the eyelids, which were reduced to a mere slit; and fear of impending insanity. Antipyrin had been taken for about 10 day and persisted in because of the gravity of the symptoms, which, including pains in the limbs and prostration, seemed to point to the necessity of active treatment. Finally a medical man was called in and the drug stopped: but the patient never rallied and died 2 day later. (JENNINGS, Lancet, Jan. 11, 1890.)
2. Two patients, a boy and a woman, aet. 10 and 67 respectively, suffered from an eruption after the internal administration of A. The eruption consisted of little irregularly rounded pimples lying close together, and in some places confluent, so as to form patches of greater or less extent, between which the skin was normal, thus giving a marbled appearance to the surface. After about 5 day the eruption began to fade, and to assume the character of a brownish pigmentation; in the old woman there were some faint evidences of desquamation. Traces of the eruption were still visible at the end of 2 weeks. The eruption was thickest over the body and in the extremities; the extensor were more covered than the flexor surfaces. In the boy there was some oedema of the face, but in neither case was there any eruption on head or neck; the palms and soles were not spared. There was some itching in the case of the woman, but the boy did not complain of this. The eruption ran its course and disappeared, although the administration of the A. was not interrupted. (Pract., Feb., 1885.)
3. A woman, aet. 35, was suffering from blood – poisoning simulating typhoid fever. On the 3rd day of her being in the hospital, temp. being 103.6 (the highest point it had reached), 35 gr. of A. were administered at 3 p. m., followed 3 hours later by half the quantity. At 6 p. m. temp. was 98.4, patient pale and still, pulse feeble and rapid. she passed a restless n., had diarrhoea and vomiting, skin cool and perspiring. Temp. next m. was 98. she died in collapse at 11 p. m. In the last 1/2 hours of her life temp. rose again to 100.6. (Lancet, Feb. 28, 1885.)
4. TUCZEK reports the case of a strong healthy boy, aet. 4, who had never had convulsions, rickets, or worms. He had been suffering from whooping – cough, and had taken for three weeks, with marked benefit, 18 gr. of A. daily, when he fell into a condition of somnolence, which had been preceded by lassitude and vomiting, and passed next day into sopor. In this condition he showed grave motor symptoms – paroxysmal epileptic attacks, some of which were complete, with general convulsions following in regular order, others incomplete, with partial unilateral twitching; contraction of muscles; chattering of teeth; jactitation; a peculiar type of breathing somewhat resembling that known as “cheyne – Stokes'”; cardiac irregularity, and dilatation of pupils. At the same time a macular eruption of scarlet red colour made its appearance, with sub – normal temp. and slow tense pulse. On 3rd d consciousness returned, the attacks lessened, and from the 4th day. there was no return. The A. was of course discontinued at the outset of the seizure. ( Practitioner, July, 1889.)
5. In an extensive use of A. in the treatment of whooping – cough, LOEWE met with 3 cases where the action was injurious and attended by alarming symptoms. In one child of 14 mos. a state of great excitement set in after the first dose. The attacks were increased and accompanied by vomiting, the child crying continually, and being thought to be dying. Hydropathic treatment relieved the condition. A second infant, 6 mos. old, after the 2nd =or 3rd dose showed cyanosis and collapse, which the same treatment removed. To satisfy himself as to the drug being the cause of these symptoms, Loewe administered a dose himself, when they shortly set in again. In a third child, aet. 2, the attacks appeared to be increased by A., so that besides laryngeal spasm and vomiting general convulsions of marked severity followed the use of the drug. (Ibid.)
6. Two man of 50, suffering from sciatica, 5 gr. were prescribed ter die. the first (and only) dose was taken at 11:30 a. m. He instantly experienced a sensation of tingling and burning in his gums, which rapidly extended to throat and nose, accompanied by sneezing, running from eyes and nostrils, dizziness, complete loss of vision, a feeling as of numberless pins pricking him down each side of the neck, tightness in throat, and dyspnoea. The pin – pricking sensation extended rapidly down the right chest and abdomen, was particularly severe in right side of scrotum and r testicle, and was also felt in legs and feet – severely in right and slightly in I. He next experienced a sensation as if contents of thorax and abdomen were being forcibly drawn upwards toward throat, and r testicle toward abdomen; so that, he said, he was “drawn in a runk,” and, being no longer able to stand, fell on the floor. He trembled violently all over, and had cramp in his right arm and hand. His physician arrived 15 m. after he had taken dose, and found him sitting in a chair, declaring that he was unable to remain recumbent. His face was of a dusky red colour; his nose, lips and eyelids were so swollen as to render his features quite unrecognizable; he was trembling violently all over, and fingers of right hand were clenched in the form of a claw. Pulse scarcely perceptible. The symptoms gradually subsided; and next day, save for slight headache and loss of appetite, he had completely recovered. (Brit. Medorrhinum Journ., June 15th, 1889.)
7. A lady, sensitive even to homoeopathic medicines, took 10 gr. for headache at 6 p. m. In 5m.. she was seized with tingling burning sensation round upper part of mouth, inside nostrils, and in palate, just like cayenne pepper; this was immediately followed by inefficient desire to sneeze; thin clear water poured from both nostrils. These symptoms ceased as suddenly as they had begun, and were immediately followed by sensation of dryness and burning in left side of throat, with instantaneous swelling there, and for a few movements absolute loss of voice. The aphonia soon gave way to hoarseness, with much coughing and expectoration which seemed to come from back of throat and nose. With these symptoms there was a lump about an inch thick in left cheek, just below level of upper teeth. Head perfectly clear but great nervous anxiety; trembling of limbs and weakness in walking. These symptoms continued till 10 p;. m., when swelling in throat was relieved by sleep and hot drinks but hoarseness was unchanged. At 3 a. m.., after further sleep, swelling in throat had almost entirely gone, but same burning ringing sensation was felt in vagina, also nervous pains all over body. She now also had two fainting – spells, with sensation of heart stopping; also throbbing all over body, coldness of hands and feet, and nervous shuddering without chill. After taking a little brandy and water, she slept again, and at 7 a. m. all symptoms had gone save the hoarseness, with weakness. Lump in mouth passed away in 1/2 h. During the first symptoms, Il corner of mouth showed a tendency to draw down. During day hoarseness continued, with faintness; frequent passage f clear urine, copious, all the time; tongue white. Had a little delirium during sleep last n., seeing face. Yesterday she looked at her throat in a mirror, and found it white, with left tonsil inflamed and swollen. (Belladonna soon removed remaining symptoms, though weakness persisted some days.). (BERRIDGE, Hom. Phys., Feb., 1890, p.89.).
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.