772 HENRY G. BARBOUR 



the arterial oxygen in dogs, the carbon dioxid being reduced to a slight 

 extent. In general then the tendency is toward the side of acidosis. 



Quinin and its congeners. Although it is not a dependable anti- 

 pyretic in many instances, Solis Cohen has recommended the use of quinin 

 in pneumonia; the initial dose is 1-1.6 grams of the quinin-urea hydro- 

 chlorid, to be followed by 1 gram doses every* three hours until the tem- 

 perature is reduced to 102 F., which may require a day or two. Cahn- 

 Bronner maintains that in certain lung inflammations treated with 0.5 

 gram doses of quinin subcutaneously an early antipyretic effect was seen 

 and the mortality reduced to one-fourth. It may be of some real etiotropic 

 value in this condition. 



In malaria the drug only prevents "chills" and further symptoms 

 rather than modifying the temperature curve after.it has begun to rise. 

 Certainly it does not compare favorably with other antipyretics in mild 

 fever. Quinin is probably only antipyretic in nearly or quite toxic doses, 

 when it acts very similarly to other types of antipyretic drugs. 



Ethylhydrocuprein has a lesser antipyretic effect than quinin, as shown 

 by Smith and Fantus. 



Cinchophea (Atophan). Cinchophen, according to Starkenstein and 

 Wiechowski, reduces the temperature of normal rabbits by several degrees. 

 Its real therapeutic value perhaps lies more in its analgesic properties 

 (which it shares with other antipyretics) than in its influence upon the 

 purin metabolism. For example, a number of compounds chemically 

 related to cinchophen, but possessing no influence upon uric acid excretion 

 were found by Klemperer to diminish in time and intensity the inflam- 

 matory phenomena of acute gout attacks. Boeck as well as Rotter has 

 described the action of a number of other derivatives. 



Purin Metabolism. Nicolaier and Dohrn introduced cinchophen for 

 the treatment of gout, having noted that three grams given daily to 

 normal individuals increased the uric acid excretion sometimes up to 200 

 per cent of the normal. (6-gram doses tripled the output.) The in- 

 creased excretion begins within an hour, the maximum being reached 

 within two hours (Griesbach and Samson). The uric acid concentration 

 shows, according to Haskins(&) (c), a compensatory decrease, sometimes 

 during administration. 



The increase of uric acid is often so great that it precipitates in the 

 urine before it is passed. Haskins has in fact shown that cinchophen in- 

 terferes with the urate-solvent action of the urine. 



Zuelzer(&) maintains that the urate excretion is more prolonged in 

 gout than in health. 



Among the theories advanced to account for the action of cinchophen 

 are increased destruction of nucleo-protein ( Schittenhelm and Ullman) 

 and conversion of absorbed uric acid into a filterable form (Frank and 

 Pietrulla). Since, however, Folin and Lyman(6) were able to show a 



