140 
Drug  Intoxication. 
/Am.  Jour.  Pharm. 
1      March,  1915. 
Quinine,  for  instance,  the  alkaloid  of  cinchona  bark,  is  still  used 
in  rather  large  quantities  and  as  such  or  in  the  form  of  bark  was 
imported  into  the  United  States,  in  1913,  to  the  total  of  2,065,000,000 
average  doses;  enough  to  give  every  man,  woman,  and  child  from 
twenty-five  to  thirty  doses  each  year.  This  drug  has  long  been  known 
to  produce  a  characteristic  form  of  intoxication  accompanied  by 
roaring  in  the  ears,  impairment  of  hearing,  dizziness,  headache  and 
nausea.  Gastro-intestinal  disturbances  are  also  observed  at  times 
and  the  ingestion  of  even  small  doses  for  a  considerable  period  may 
be  followed  by  gastric  catarrh,  and  its  sequelae.  The  administration 
of  larger  doses  has  been  followed  by  marked  and  at  times  persistent 
deafness  and  even  blindness. 
The  habitual  ingestion  of  coal-tar  analgesics,  which  form  para- 
aminophenol,  is  followed  by  a  train  of  symptoms  including  destruc- 
tive changes  in  the  blood,  the  production  of  methgemoglobin,  a  de- 
generation of  the  heart  muscle,  cardiac  failure,  cyanosis,  abnormally 
low  temperature,  and  collapse. 
The  salicylates  have  many  of  the  properties  of  coal-tar  analgesics 
and  are  used  quite  extensively  as  sedatives  for  the  relief  of  headache 
and  neuralgic  pains.  They  are  known  to  have  a  deleterious  influence 
on  the  digestive  function  and  in  larger  doses  or  when  long  continued 
are  frequently  accompanied  by  symptoms  of  cinchonism  similar  to 
those  produced  by  quinine.  The  salicylates  may  also  have  a  depress- 
ing influence  on  the  central  nervous  system  accompanied  by  convul- 
sions, slowing  of  respiration,  and  collapse  from  circulatory  depression. 
Pontius  (/.  Am.  M.  Assoc.,  vol.  62,  p.  797)  reports  seeing  a  ner- 
vous woman,  age  forty-five,  who  on  the  advice  of  a  friend  had  for 
the  past  year  taken  five-grain  tablets  (one  per  dose)  from  three  to 
ten  times  daily  for  neuralgic  pains.  Her  mental  condition  when  seen 
by  the  physician  was  similar  to  that  of  one  addicted  to  the  morphine 
habit. 
The  coal-tar  hypnotics  like  sulphonal  and  trional  may  cause  acute 
symptoms  of  poisoning  accompanied  by  ataxia,  nausea,  gastric  pain, 
irritation  of  the  kidneys,  albuminuria,  and  nephritis. 
The  mental  state  induced  by  the  long-continued  use  of  sulphonal 
and  its  congeners  in  full  doses  is  said  to  be  a  badly  disturbed  one 
with  derangement  and  even  dementia. 
The  occurrence  of  acute  intoxication  in  patients  from  the  ingestion 
of  various  drugs  is  frequently  ascribed  to  idiosyncrasy.  As  yet  com- 
paratively little  is  known  regarding  the  principles  underlying  this 
