LITERATURE ON ANTIPYRIN POISONING. 47 



The-> figures indicate either that there has been a considerable 

 falling tf in the use of antipyrin during recent years, or that the 

 driii: has been employed with greater caution and discrimination, 

 and undoubtedly both of these factors have played an important part 

 in reducing the number of cases of poisoning. The inefficiency of 

 the drug in the treatment of some of the affections for which it was 

 formerly recommended and the uncertainty of the effect of its admin- 

 istration may have contributed to this decrease. A review of the 

 cases herein recorded will -how that in a number of instances a single 

 do-e of antipyrin of :> grain- or less has produced alarming symptoms 

 in adult-, while a dose of 10 or !."> grains has produced serious col- 

 lap.-e. In many cases of harmful results the dose appears to have 

 been neither unduly large nor too long continued, and there seems to 

 have been little, if any. direct relation between the size of dose and 

 the occurrence and -e\erity of the ill effects. Furthermore, untoward 

 -vmptoms have appeared so promptly in many cases as to lead some 

 ob06TTen to believe that the manifestations are largely reflex in 

 character, ina-much a- there appeared to be almost no time allowed 

 for absorption of the drug fnmi the stomach between the time of 

 iiigt-tion and the appearance of the symptoms. This uncertainty of 

 Ltfl bafl undoubtedly been an important factor in bringing about a 

 more eoii-er\Mti\e 088 of the drug. 



ABSTRACTS OF ANTIPYRIN CASES. 

 CUTANEOUS MANIFESTATIONS. 



Tnder thi- heading an grouped the recorded cases of antipyrin 

 poisoning in which the ciitaneou- -ymptoms appear to have occupied 

 the mn.-t inijx. riant place in the clinical history. They are, how- 

 ever, not nece^arily the only ones described in the published reports, 

 and cutaneou- manifestation- are recorded in many of the cases 

 which have been grouped under other headings. 



A renew of the reported cases shows that the cutaneous symptoms 

 pre-ented them-elve^ ino-t often in the form of a rash or eruption, 

 often accompanied by -welling and severe itching. The eruption 

 appeared in widely different forms, and varied much in the different 

 cases as regards character, time of appearance, duration, part of 

 the body affected, severity, etc. The form which appears to have 

 been observed most frequently was that of urticaria, accompanied by 

 re itching. In other cases the eruption resembled that of scarlet 

 fever, in others that of measles, and in still others that of herpes, 

 ems, or pemphigus. In most of the cases the symptoms appeared 

 promptly after the ingestion of one or two doses of the drug; m 

 some, however, they were delayed, and in not a few instances the 

 cutaneous manifestations did not make their appearance until after 



