l.ll K1IAT! IM. ON ACETANILID POISONING. 23 



the number averaged but six annually. Since the 

 yea i- I'.x'l. however, there has been a notable increase in the number 

 of cases reported M well as in the number of fatalities. This can be 

 adequately explained by the fact that during recent years the control 

 of a< -ctanilid as a remedial agent has rapidly passed from the hands 

 of the medical profusion to those of the laity, owing largely to the 

 advertising etlori- of the manufacturers of proprietary medicines, 

 and the increa-e in the number of ea-es reported and in the number of 

 fatalities i- undoubtedly mainly due to the ill-advised and promiscu- 

 ous MM. of acetanilid preparations by the laity for the relief of 

 headache and other minor ills. 



Of the i".'T cases reported. !", or 4.3 per cent, terminated fatally. 

 'Ill' 1 number of death- occurring each year is set forth in the follow- 

 ing table. 



I <it"l 0Mei <>f <ir<liinili<l futixnn /////. 



IN" ...rt.-il fnr the years omitted.] 



[t is ii.iciv-i ing to nnie that although 185, or 02.2 per cent, of all 

 theca-e- were reported during the first four and one-half years of the 

 hi-tory of acei.-inilid :l ^ a medicine, the number of deaths from acet- 

 anilid |oi-oning \\hieh occurred during this time was only 3 or 1.0 

 per cent : \\ hri,-a> <luring the last three years, since the drug has been 

 ii-ed more <.r le-> iudisrrimimitely by the public, the percentage of 

 Natalities reported has hi'en H.r> j)er cent. 



In -J',. <!i s.; p ( . r ,-cut, of the cases reported, poisoning resulted from 

 external application. These cases are of particular interest as they 

 afford an illustration of the toxic power of acetanilid. In one of 

 these cases the poisoning resulted fatally. The following abstract 

 taken from a report by (Jartman and Ball in 1897 6 gives an illustra- 

 tion of the clinical picture in this class of cases: 



riill. 3J yenrs old. A scalded area of skin was dressed with three ounces of 

 a 10 i>er cent ointment of acetanilid. Two days later three ounces were again 

 a [.plied, and the child began to turn blue. The cyanosis deepened until the 

 skin .-mil visil.lr mucous membranes were of a blackish-blue color, and symptoms 



Rook, C. W Poisoning by acetanilid. J. Amer. Med. Assn., 1896, 26 : 239. 

 b A case of acvtanilid poisoning. Philadelphia Polyclynic, 1897, 6: 381. 



