22 



ACETANILID, ANTIPYRIN, AND PHENACETIN. 



The total number of cases of poisoning herein described is 297 or 

 more, reported by 177 observers. The exact number of cases can not 

 be determined with accuracy, inasmuch as some of the authors refer 

 to the number of cases observed by them under such indefinite terms 

 as "several," "many," "a few," etc. The number of cases reported 

 for each year is set forth in the f olloAving table : 



Case* of <K-<i<inili(l 



rcctirdrd, 1X86-1907. 



Of the total number of cases recorded, 114, or more than one-third 

 (38 per cent), were reported during the year and a half following 

 the advent of acetanilid as a medicinal ag$nt in August, 1880, and 

 185, or more than one-half (62.2 per cent), were reported during the 

 first four and a half years of its history. The occurrence of so large 

 a proportion of the cases during this period was undoubtedly due in 

 part to the fact that at this time the toxic properties of acetanilid 

 were not understood and its possibilities for harm were not known or 

 appreciated. This is shown by the fact that it was at first used almost 

 entirely as an antipyretic in febrile diseases and was administered 

 rather freely to sthenic and asthenic patients alike, to those suffer- 

 ing from debilitating diseases like typhoid fever, as well as to robust 

 patients suffering merely from minor aches or pains. The results of 

 this free administration were disastrous, and the number of instances 

 in which death was hastened by ill-advised use of acetanilid during 

 the early years of its history can only be surmised. After the drug 

 had been more thoroughly studied, however, and after its injurious 

 effects in many cases had been brought to the attention of the pro- 

 fession, partly through personal experience and partly through re- 

 ports published in the medical press, its possibilities for harm came 

 to be more fully appreciated and it was used more and more con- 

 servatively, particularly in asthenic cases. As a result, the number 

 of cases of poisoning fell off rapidly and during the thirteen years 



