18 ACETANILID, ANTIPYRIN, AND PHENACETIN. 



Out of the 368 cases in which the dose of acetanilid administered 

 to adults was stated, the poisoning was caused by doses of 5 grains or 

 more in 331, or 89.9 per cent; with antip} T rin the ill effects were 

 caused by doses of 10 grains or more in 89.7 per cent of the cases, 

 while with phenacetin the toxic effects were caused by tloses of 10 

 grains or more in 67.8 per cent of the cases, and by doses of 5 grains 

 or more in 93.2 per cent of the cases. 



In 85.7 per cent of the cases the poisonous effects of acetanilid ad- 

 ministered to children were caused by doses of 2 grains or more ; with 

 antipyrin the ill effects were due to doses of 3 grains or more in 85.7 

 per cent of the cases, while with phenacetin no ill effects were re- 

 ported to have resulted from doses under 2 grains. 



QUESTION 13. GIVE BRIEF HISTORY OF CASES OBSERVED BY You, OMITTING 



DETAILS. 



The information submitted in answer to this inquiry is given in 

 connection with the replies to the remaining questions. 



QUESTION 14. HAVE You OBSERVED ANY CASES OF HABITUAL USE OF ANY OF 

 THESE DRUGS OR OF ANY PREPARATION CONTAINING THEM 'i 



An endeavor was made to obtain information with regard to the 

 extent to .which these drugs are used habitually, as it has long been 

 known that acetanilid, antipyrin, and phenacetin are habit-forming 

 drugs, particularly acetanilid. The habit is acquired in most in- 

 stances through the use of the remedy without the supervision of the 

 physician for the relief of minor aches and pains, especially headache. 

 These affections are usually of a recurrent character and, the remedy 

 exerting but a palliative effect, the dose after a time must be repeated 

 and in time the patient may become dependent on the drug. Further- 

 more, j:he prolonged or habitual use of these agents tends to produce 

 an impaired condition of the general health which, as in all such 

 cases, is accompanied by a lessened resistance on the part of the 

 body to disease. Under these circumstances the affection for which 

 the remedy was originally taken assumes greater proportions than 

 ever, and as a result there is additional call for the drug. Thus a 

 vicious circle is established more drug, impaired bodily health, 

 lessened resistance, more pain, more drug. 



It has been said that in its baneful effects on the system and in 

 the difficulty which is experienced in giving up the use of these 

 drugs in many instances, the habit ranks as an evil with the opium 

 habit. Whether this is true or not, there can be no reasonable doubt 

 that their prolonged or habitual use is decidedly harmful to the sys- 

 tem. In spite of this fact, the habitual use of these agents is spread- 

 ing among the people and it is becoming more and more apparent 



